| NPI | 1578769105 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOEY S. TIRADOR President/CEO 760-256-1189 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CA 50993) |
| Enumeration Date | 2007-06-21 |
| Last Update Date | 2008-06-17 |