| NPI | 1679873186 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EDMUND WALT JAY President / Owner Dentist 858-270-0682 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center (Licence: CA 36384) |
| Enumeration Date | 2010-10-31 |
| Last Update Date | 2010-10-31 |