| NPI | 1700915808 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOSE L. LOPEZ President Of Corporation 619-423-1351 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: CA 44013) |
| Enumeration Date | 2007-03-05 |
| Last Update Date | 2020-08-22 |