| NPI | 1972214757 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRADLEY UDELL SAINSBURY Owner/Provider 619-466-2774 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X2210X Dentist, Orofacial Pain |
| Additional Taxonomies | 261QD0000X Clinic/Center, Dental |
| 1223S0112X Dentist, Oral and Maxillofacial Surgery | |
| Enumeration Date | 2022-12-12 |
| Last Update Date | 2026-06-05 |