| NPI | 1871071795 |
|---|---|
| Doing Business As | SERRA MESA MODERN DENTISTRY DENTAL GROUP |
| Entity Type | Organization |
| Authorized Contact | GRACE C FEDOR Owner 858-617-0620 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist |
| Enumeration Date | 2018-08-02 |
| Last Update Date | 2022-03-08 |