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2451 Jamacha Road Sutie 104 El Cajon CA 92019-4324 | |
| (619) 444-0500 | |
| (619) 444-2803 |
| Full Name | |
|---|---|
| Speciality | Dentist |
| Location | 2451 Jamacha Road, El Cajon, California |
| Authorized Official Name and Position | Kevin Osborn (PRESIDENT) |
| Authorized Official Contact | 6194440500 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
2451 Jamacha Rd Sutie 104 El Cajon CA 92019-6319 Ph: (619) 444-0500 | 2451 Jamacha Road Sutie 104 El Cajon CA 92019-4324 Ph: (619) 444-0500 |
| NPI Number | 1164762829 |
|---|---|
| Provider Enumeration Date | 02/18/2013 |
| Last Update Date | 02/18/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1164762829 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 42866 (California) | Primary |
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