| NPI | 1497946933 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NICK PAVLOV Dentist 858-459-5591 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CA 44055) |
| Additional Taxonomies | 261QD0000X Clinic/Center, Dental (Licence: CA 44055) |
| Enumeration Date | 2007-08-08 |
| Last Update Date | 2008-05-28 |