| NPI | 1649013343 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | YI YUAN Owner Dentist 619-870-0858 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice |
| Additional Taxonomies | 122300000X Dentist |
| Enumeration Date | 2024-06-18 |
| Last Update Date | 2024-06-18 |