| NPI | 1922276765 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | THOMAS L RODERICK Owner 619-574-1810 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CA 33655) |
| Enumeration Date | 2008-02-14 |
| Last Update Date | 2008-02-14 |