| NPI | 1821599630 |
|---|---|
| Former Legal Business Name | JUAN P MEDINA |
| Entity Type | Organization |
| Authorized Contact | JUAN P MEDINA Dentist 619-488-3200 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: 6325168) |
| Enumeration Date | 2018-02-27 |
| Last Update Date | 2018-02-27 |