| NPI | 1760120810 |
|---|---|
| Doing Business As | COLLEGE AVENUE DENTISTRY |
| Entity Type | Organization |
| Authorized Contact | RISHAAD TARAPOREWALLA Owner 619-398-0624 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice |
| Enumeration Date | 2022-05-26 |
| Last Update Date | 2022-05-26 |