| NPI | 1730485657 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN EMERY TILLNER Doctor/President 619-482-6774 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: CA 52944) |
| Enumeration Date | 2011-02-10 |
| Last Update Date | 2011-02-10 |