| NPI | 1710340294 |
|---|---|
| Doing Business As | ENCINITAS SMILES DENTISTRY DENTAL GROUP |
| Entity Type | Organization |
| Authorized Contact | CLINTON H PARK Owner 760-388-2161 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist |
| Enumeration Date | 2016-04-01 |
| Last Update Date | 2016-04-01 |