| NPI | 1821223934 |
|---|---|
| Doing Business As | EASTLAKE IMPLANT & LASER DENTISTRY |
| Entity Type | Organization |
| Authorized Contact | EDUARDO DIAZ President 619-216-0111 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center Dental (Licence: CA 44306) |
| Enumeration Date | 2009-05-18 |
| Last Update Date | 2011-08-04 |