| NPI | 1619478963 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TERESA ROSAS Dentist 619-488-3200 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist Orthodontics and Dentofacial Orthopedics (Licence: 3188041) |
| Enumeration Date | 2018-02-22 |
| Last Update Date | 2018-02-22 |