| NPI | 1659906055 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JONATHAN DAVID ALBAUGH Owner 760-527-2846 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics |
| Enumeration Date | 2020-03-05 |
| Last Update Date | 2020-12-08 |