| NPI | 1508075086 |
|---|---|
| Doing Business As | LA COSTA DEL SUR DENTAL PRACTICE |
| Entity Type | Organization |
| Authorized Contact | GERALD MIYAMOTO President 760-942-5888 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CA 47291) |
| Enumeration Date | 2007-05-22 |
| Last Update Date | 2009-02-19 |