| NPI | 1922280874 |
|---|---|
| Doing Business As | BONITA DENTAL CENTER |
| Entity Type | Organization |
| Authorized Contact | GREGORY PARKE DAVIS President 619-267-2115 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: CA 21869) |
| Enumeration Date | 2007-12-03 |
| Last Update Date | 2007-12-03 |