| NPI | 1558884239 |
|---|---|
| Doing Business As | MENIFEE LAKES DENTAL GROUP |
| Entity Type | Organization |
| Authorized Contact | POULSEN D KYLE Owner 951-228-9296 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist |
| Enumeration Date | 2017-07-25 |
| Last Update Date | 2022-03-08 |