| NPI | 1578716148 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBERT D. KRAUSE Owner 619-445-8896 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: CA 29162) |
| Additional Taxonomies | 122300000X Dentist (Licence: CA 47454) |
| Enumeration Date | 2008-10-28 |
| Last Update Date | 2008-10-28 |