| Coast Dental Practice | |
|
1304 S Miller St Santa Maria CA 93454-6904 | |
| (805) 352-1188 | |
| (805) 352-2078 |
| Full Name | Coast Dental Practice |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 1304 S Miller St, Santa Maria, California |
| Authorized Official Name and Position | Ghassan R Antaki (OWNER) |
| Authorized Official Contact | 8053521188 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Coast Dental Practice 1304 S Miller St Santa Maria CA 93454-6904 Ph: (805) 352-1188 | Coast Dental Practice 1304 S Miller St Santa Maria CA 93454-6904 Ph: (805) 352-1188 |
| NPI Number | 1649357880 |
|---|---|
| Provider Enumeration Date | 11/01/2006 |
| Last Update Date | 07/14/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1649357880 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 38024 (California) | Primary |
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