| Bonita Dental Center | |
|
5050 Bonita Rd Bonita CA 91902-1701 | |
| (619) 267-2115 | |
| (619) 354-4166 |
| Full Name | Bonita Dental Center |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 5050 Bonita Rd, Bonita, California |
| Authorized Official Name and Position | Todd Ludden (ASSOCIATE) |
| Authorized Official Contact | 6192672115 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Bonita Dental Center 5050 Bonita Rd Bonita CA 91902-1701 Ph: (619) 267-2115 | Bonita Dental Center 5050 Bonita Rd Bonita CA 91902-1701 Ph: (619) 267-2115 |
| NPI Number | 1588171235 |
|---|---|
| Provider Enumeration Date | 01/03/2018 |
| Last Update Date | 11/12/2019 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1588171235 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | 61894 (California) | Primary |
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