| NPI | 1831382993 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CARRIE ELDRIDGE Office Mgr. 858-578-0277 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CA 46495) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: CA 49791) |
| Enumeration Date | 2007-08-22 |
| Last Update Date | 2007-08-22 |