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 |