| NPI | 1972002954 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEFFERY SCOTT SCHAEFER Owner 760-613-2049 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center Dental (Licence: CA 62593) |
| Enumeration Date | 2018-02-06 |
| Last Update Date | 2018-02-06 |