| NPI | 1992501183 |
|---|---|
| Doing Business As | BOUTIQUE ORTHODONTICS |
| Entity Type | Organization |
| Authorized Contact | JOSE CASTILLO President 858-454-7111 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics |
| Additional Taxonomies | 1223P0221X Dentist, Pediatric Dentistry |
| 261QD0000X Clinic/Center, Dental | |
| Enumeration Date | 2025-02-20 |
| Last Update Date | 2025-02-20 |