| 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 |