| NPI | 1780445601 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RAYMOND E CARPENTER Owner 858-775-6361 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery |
| Additional Taxonomies | 1223P0700X Dentist, Prosthodontics |
| 1223X2210X Dentist, Orofacial Pain | |
| Enumeration Date | 2024-01-18 |
| Last Update Date | 2024-04-18 |