| Arthur Santos Dds Corp | |
|
12110 Woodside Ave Lakeside CA 92040-3012 | |
| (619) 443-0444 | |
| Not Available |
| Full Name | Arthur Santos Dds Corp |
|---|---|
| Speciality | Clinic/Center |
| Location | 12110 Woodside Ave, Lakeside, California |
| Authorized Official Name and Position | Arthur David Santos (PRESIDENT) |
| Authorized Official Contact | 6199850720 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Arthur Santos Dds Corp 12110 Woodside Ave Lakeside CA 92040-3012 Ph: (619) 443-0444 | Arthur Santos Dds Corp 12110 Woodside Ave Lakeside CA 92040-3012 Ph: (619) 443-0444 |
| NPI Number | 1770940637 |
|---|---|
| Provider Enumeration Date | 01/24/2016 |
| Last Update Date | 01/24/2016 |
| Medicare PECOS PAC ID | 7517398209 |
|---|---|
| Medicare Enrollment ID | O20200513001555 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1770940637 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | 62050 (California) | Primary |
| Provider Name | Arthur David Santos |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1093059651 PECOS PAC ID: 8426489113 Enrollment ID: I20200518002846 |
| Provider Name | Ivan Jonathan Santos |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1659730182 PECOS PAC ID: 9739510173 Enrollment ID: I20200519000622 |
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