| NPI | 1770980930 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARTIN ORTIZ OLIVEROS President 760-757-5037 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CA 52444) |
| Enumeration Date | 2014-12-03 |
| Last Update Date | 2014-12-03 |