| Care To Share Smile | |
|
440 S Melrose Dr Ste 100 Vista CA 92081-6666 | |
| (858) 229-9869 | |
| Not Available |
| Full Name | Care To Share Smile |
|---|---|
| Speciality | Dentist |
| Location | 440 S Melrose Dr Ste 100, Vista, California |
| Authorized Official Name and Position | Samuel Soonho Lee (PRESIDENT) |
| Authorized Official Contact | 8582299869 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Care To Share Smile 5110 Rancho Verde Trl San Diego CA 92130-5244 Ph: (858) 229-9869 | Care To Share Smile 440 S Melrose Dr Ste 100 Vista CA 92081-6666 Ph: (858) 229-9869 |
| NPI Number | 1972378362 |
|---|---|
| Provider Enumeration Date | 11/16/2023 |
| Last Update Date | 11/16/2023 |
| Medicare PECOS PAC ID | 1052751757 |
|---|---|
| Medicare Enrollment ID | O20240429001755 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1972378362 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0300X | Dentist - Periodontics | (* (Not Available)) | Primary |
| Provider Name | Samuel Soonho Lee |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1851418255 PECOS PAC ID: 2961842661 Enrollment ID: I20240429001897 |
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