| NPI | 1770132631 |
|---|---|
| Former Legal Business Name | VICTOR MEDINA |
| Entity Type | Organization |
| Authorized Contact | VICTOR MEDINA Dentits 619-488-3200 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice |
| Enumeration Date | 2019-09-04 |
| Last Update Date | 2019-09-04 |