| NPI | 1558891291 |
|---|---|
| Doing Business As | BEAUTIFUL SMILES OF LA JOLLA |
| Entity Type | Organization |
| Authorized Contact | RICHARD EVANGELISTA President 925-789-0575 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: CA 47258) |
| Enumeration Date | 2017-06-15 |
| Last Update Date | 2022-07-21 |