| NPI | 1518760065 |
|---|---|
| Doing Business As | BALBOA ISLAND DENTISTRY |
| Entity Type | Organization |
| Authorized Contact | AMANDA RAE KRONQUIST Partner 949-673-7820 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist |
| Enumeration Date | 2025-03-31 |
| Last Update Date | 2025-03-31 |