| NPI | 1972013175 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TAYLOR S MOTA Manager 619-737-7700 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: CA 41016) |
| Enumeration Date | 2017-10-03 |
| Last Update Date | 2017-10-03 |