| NPI | 1972735181 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KELLY RYAN TAYLOR Orthodontist 760-434-7645 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics |
| Enumeration Date | 2009-08-20 |
| Last Update Date | 2011-06-08 |