| NPI | 1962726950 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TERRI SAWDEY Office Manager 760-340-0888 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: PA 033244) |
| Additional Taxonomies | 1223P0300X Dentist, Periodontics (Licence: PA 33245) |
| 1223P0700X Dentist, Prosthodontics (Licence: PA 33245) | |
| Enumeration Date | 2010-03-18 |
| Last Update Date | 2010-03-18 |