NPI | 1992157655 |
---|---|
Entity Type | Organization |
Authorized Contact | LUIS E REAL President Owner 619-851-8125 |
Organization Subpart ? | No |
Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: CA 52460) |
Enumeration Date | 2016-07-06 |
Last Update Date | 2016-07-06 |