| Blue Mountain Dentistry | |
|
6171 Mission Gorge Road Suite #114 San Diego CA 92120 | |
| (858) 617-9051 | |
| Not Available |
| Full Name | Blue Mountain Dentistry |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 6171 Mission Gorge Road, San Diego, California |
| Authorized Official Name and Position | Morteza Khatibzad (DENTIST) |
| Authorized Official Contact | 8586179051 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Blue Mountain Dentistry 6171 Mission Gorge Rd Ste 114 San Diego CA 92120-3409 Ph: () - | Blue Mountain Dentistry 6171 Mission Gorge Road Suite #114 San Diego CA 92120 Ph: (858) 617-9051 |
| NPI Number | 1548782923 |
|---|---|
| Provider Enumeration Date | 07/07/2017 |
| Last Update Date | 07/07/2017 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1548782923 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | 55489 (California) | Primary |
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