| NPI | 1760960033 |
|---|---|
| Former Legal Business Name | MELISSA MACIAS |
| Entity Type | Organization |
| Authorized Contact | MELISSA MACIAS Dentist 619-488-3200 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: 7463342) |
| Enumeration Date | 2018-07-30 |
| Last Update Date | 2018-07-30 |