| NPI | 1982903324 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MITCHELL B POISET Owner/CEO 858-492-9977 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: CA B32650) |
| Additional Taxonomies | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: CA B32650) |
| Enumeration Date | 2011-03-24 |
| Last Update Date | 2021-08-17 |