| NPI | 1548540123 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PAMELA JANE GARDNER Office Manager 619-224-4225 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CA 40730) |
| Enumeration Date | 2011-08-26 |
| Last Update Date | 2011-08-26 |