| NPI | 1831414200 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VANESSA L CARRILLO Office Manager 858-755-9810 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0700X Dentist Prosthodontics (Licence: CA 41411) |
| Enumeration Date | 2010-03-29 |
| Last Update Date | 2010-03-29 |