| NPI | 1811183478 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CORINNE KAY PHILLIPS Office Manager 619-464-3631 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: CA 24887) |
| Enumeration Date | 2007-09-18 |
| Last Update Date | 2012-11-26 |