NPI | 1710155973 |
---|---|
Entity Type | Organization |
Authorized Contact | VALERIE JOHNSON MASTROVICH Business Manager 760-741-6650 |
Organization Subpart ? | No |
Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CA 26090) |
Enumeration Date | 2008-02-11 |
Last Update Date | 2008-02-11 |