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 |