| NPI | 1629385380 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN BAKER Member 619-977-1250 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: CA 52768) |
| Enumeration Date | 2010-09-01 |
| Last Update Date | 2010-09-01 |