| NPI | 1548775349 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JORDAN DARWIN COLBY Owner 760-723-3535 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CA 64552) |
| Enumeration Date | 2017-12-04 |
| Last Update Date | 2022-07-21 |