| NPI | 1982896163 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL JAMES NELSON Owner 760-471-9560 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CA 33641) |
| Enumeration Date | 2007-08-13 |
| Last Update Date | 2007-08-13 |