Advanced Dentistry Of San Diego | |
630 S Melrose Dr Ste B Vista CA 92081-6626 | |
(760) 726-5703 | |
Not Available |
Full Name | Advanced Dentistry Of San Diego |
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Speciality | Dentist |
Location | 630 S Melrose Dr Ste B, Vista, California |
Authorized Official Name and Position | Michael C Maksim (OWNER) |
Authorized Official Contact | 7607265703 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Advanced Dentistry Of San Diego 630 S Melrose Dr Ste B Vista CA 92081-6626 Ph: (760) 726-5703 | Advanced Dentistry Of San Diego 630 S Melrose Dr Ste B Vista CA 92081-6626 Ph: (760) 726-5703 |
NPI Number | 1477991404 |
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Provider Enumeration Date | 06/12/2013 |
Last Update Date | 06/12/2013 |
Identifier | Type | State | Issuer |
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1477991404 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
122300000X | Dentist | 35429 (California) | Primary |
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