| NPI | 1659463057 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARK WILLIAM COLLINS Owner/President 858-536-8338 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CA 37990) |
| Enumeration Date | 2006-09-30 |
| Last Update Date | 2020-08-22 |