| NPI | 1750646006 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAURA B SEVILLA President 619-292-3043 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CA 52686) |
| Enumeration Date | 2012-07-11 |
| Last Update Date | 2012-07-13 |