| NPI | 1609377878 |
|---|---|
| Former Legal Business Name | OCTAVIO IBARRA |
| Entity Type | Organization |
| Authorized Contact | OCTAVIO IBARRA Dentist 619-488-3200 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: 8693632) |
| Enumeration Date | 2018-02-23 |
| Last Update Date | 2018-02-23 |