| NPI | 1679087670 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LILIA CAMACHO RASCON Dentist 619-488-3200 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0300X Dentist, Periodontics (Licence: ZZ 8142083) |
| Enumeration Date | 2017-11-29 |
| Last Update Date | 2017-11-29 |