| NPI | 1821635285 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEPHEN EVERETT LOCKWOOD Business Partner/Dentist 858-587-9077 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center Dental |
| Enumeration Date | 2019-12-04 |
| Last Update Date | 2019-12-04 |