NPI | 1811708415 |
---|---|
Entity Type | Organization |
Authorized Contact | RAMSES ANGULO PENA Provider 619-272-9021 |
Organization Subpart ? | No |
Primary Taxonomy | 1223G0001X Dentist General Practice |
Additional Taxonomies | 1223X0400X Dentist Orthodontics and Dentofacial Orthopedics |
Enumeration Date | 2025-01-14 |
Last Update Date | 2025-01-14 |