| NPI | 1740682517 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOE A NGUYEN Dentist/Ownder 858-761-2404 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0300X Dentist, Periodontics (Licence: MA DN1855923) |
| Enumeration Date | 2014-09-23 |
| Last Update Date | 2016-07-28 |