| NPI | 1922509975 | 
|---|---|
| Former Legal Business Name | MARIA FONSECA | 
| Entity Type | Organization | 
| Authorized Contact | MARIA FONSECA Dentist 619-488-3200  | 
| Organization Subpart ? | No | 
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: 6835355)  | 
| Enumeration Date | 2018-02-26 | 
| Last Update Date | 2018-02-26 |