NPI | 1710492954 |
---|---|
Entity Type | Organization |
Authorized Contact | RICHARD ALLAN PENMAN President 760-529-4649 |
Organization Subpart ? | No |
Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: CA 44056) |
Enumeration Date | 2017-12-11 |
Last Update Date | 2017-12-11 |