| NPI | 1811390578 |
|---|---|
| Doing Business As | GOLDEN WEST DENTISTRY |
| Entity Type | Organization |
| Authorized Contact | WILBERTO ISAAC PENALBA Owner/President 951-675-2690 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CA 60504) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: CA 60505) |
| Enumeration Date | 2014-10-08 |
| Last Update Date | 2014-10-08 |