| NPI | 1508053323 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GEORGE R BRAITHWAITE Dentist/President 760-724-6537 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: CA 24937) |
| Enumeration Date | 2007-09-25 |
| Last Update Date | 2011-07-27 |