| NPI | 1750609400 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LETICIA MEDINA Secretary/Owner 805-687-1106 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CA 39448) |
| Enumeration Date | 2010-05-05 |
| Last Update Date | 2010-05-05 |