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3211 Business Park Dr Ste A Vista CA 92081-8259 | |
| (760) 727-6800 | |
| (760) 727-4225 |
| Full Name | |
|---|---|
| Speciality | Dentist |
| Location | 3211 Business Park Dr Ste A, Vista, California |
| Authorized Official Name and Position | John Baker (ADMINISTRATOR) |
| Authorized Official Contact | 7607276800 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
1477 San Pablo Dr San Marcos CA 92078-4701 Ph: (760) 727-6800 | 3211 Business Park Dr Ste A Vista CA 92081-8259 Ph: (760) 727-6800 |
| NPI Number | 1053653527 |
|---|---|
| Provider Enumeration Date | 03/22/2013 |
| Last Update Date | 03/22/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1053653527 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | (California) | Primary |
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