| NPI | 1720720469 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | THOMAS J ZANE Executive Director 619-840-8718 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice |
| Additional Taxonomies | 122300000X Dentist |
| Enumeration Date | 2022-04-12 |
| Last Update Date | 2025-10-17 |