| NPI | 1902307697 |
|---|---|
| Former Legal Business Name | JORGE VIZCARRA |
| Entity Type | Organization |
| Authorized Contact | JORGE VIZCARRA Dentist 619-488-3200 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: 4125102) |
| Enumeration Date | 2018-02-27 |
| Last Update Date | 2018-02-27 |