| NPI | 1790102127 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RANDALL W STETTLER President 619-463-4486 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: CA 39089) |
| Enumeration Date | 2014-03-24 |
| Last Update Date | 2014-04-15 |