| NPI | 1689411068 | 
|---|---|
| Entity Type | Organization | 
| Authorized Contact | RAUL ARGENIS URIAS FELIX Povider 619-272-9021  | 
| Organization Subpart ? | No | 
| Primary Taxonomy | 1223G0001X Dentist, General Practice | 
| Additional Taxonomies | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics | 
| Enumeration Date | 2024-07-11 | 
| Last Update Date | 2024-07-11 |