| NPI | 1538720354 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CESAR ALEJANDRO RUIZ GONZALEZ Administrative Director 833-246-3368 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice |
| Additional Taxonomies | 122300000X Dentist |
| Enumeration Date | 2019-06-24 |
| Last Update Date | 2019-06-24 |