| NPI | 1609333673 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JULIO E CACERES Owner 951-549-1111 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist |
| Additional Taxonomies | 1223S0112X Dentist Oral and Maxillofacial Surgery |
| Enumeration Date | 2019-02-26 |
| Last Update Date | 2023-03-07 |