| NPI | 1558862599 |
|---|---|
| Former Legal Business Name | DAVID GONGORA |
| Entity Type | Organization |
| Authorized Contact | DAVID GONGORA Dentist 619-488-3200 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: 7593837) |
| Enumeration Date | 2018-02-26 |
| Last Update Date | 2018-02-26 |