| NPI | 1508552423 |
|---|---|
| Doing Business As | ALLISON AVENUE DENTAL |
| Entity Type | Organization |
| Authorized Contact | FERNAND LACAYANGA President 619-436-9428 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental |
| Enumeration Date | 2023-04-13 |
| Last Update Date | 2023-04-13 |