| NPI | 1861527681 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | FORTUNATA R. SOTO Partner 619-275-2626 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice |
| Additional Taxonomies | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics |
| Enumeration Date | 2007-02-22 |
| Last Update Date | 2020-08-22 |