| NPI | 1801744016 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KENNETH ALEXANDER Manager 760-539-6736 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics |
| Enumeration Date | 2026-03-21 |
| Last Update Date | 2026-03-21 |