NPI | 1619069929 |
---|---|
Entity Type | Organization |
Authorized Contact | KATHERINE M TANAKA Owner 619-420-8696 |
Organization Subpart ? | No |
Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CA 39210) |
Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: CA 40575) |
Enumeration Date | 2006-09-28 |
Last Update Date | 2020-08-22 |