| NPI | 1780185017 |
|---|---|
| Former Legal Business Name | JOSE AVALOS |
| Entity Type | Organization |
| Authorized Contact | JOSE AVALOS Dentist 619-488-3200 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice |
| Enumeration Date | 2018-02-22 |
| Last Update Date | 2018-02-22 |