| NPI | 1578114971 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PAULINA ACOSTA Dentist 619-488-3200 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist Orthodontics and Dentofacial Orthopedics |
| Enumeration Date | 2019-09-26 |
| Last Update Date | 2019-09-26 |