| NPI | 1619243227 |
|---|---|
| Doing Business As | POWAY PEDIATRIC DENTISTRY |
| Entity Type | Organization |
| Authorized Contact | ROBERT WADID FATTOUCH Owner/President 858-674-4261 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: CA 60280) |
| Enumeration Date | 2012-03-28 |
| Last Update Date | 2012-03-28 |