| NPI | 1790263689 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARITES LAGAZON SOTTO Owner/Dentist 619-210-9677 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: CA 58124) |
| Enumeration Date | 2018-08-01 |
| Last Update Date | 2018-08-01 |