| NPI | 1760682686 |
|---|---|
| Doing Business As | MIRA COSTA DENTAL |
| Entity Type | Organization |
| Authorized Contact | JOSE M DUENES Owner President 760-941-7502 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: CA 35047) |
| Enumeration Date | 2007-07-19 |
| Last Update Date | 2008-07-17 |