| NPI | 1679057186 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PARAON NOLASCO DEQUIROZ President 760-815-2835 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QS0112X Clinic/Center Oral and Maxillofacial Surgery |
| Enumeration Date | 2018-09-20 |
| Last Update Date | 2018-09-20 |