| Eastlake Implant & Laser Dentistry | |
|
890 Eastlake Pkwy Suite 303 Chula Vista CA 91914-4520 | |
| (619) 216-0111 | |
| (619) 216-7081 |
| Full Name | Eastlake Implant & Laser Dentistry |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 890 Eastlake Pkwy, Chula Vista, California |
| Authorized Official Name and Position | Eduardo Diaz (PRESIDENT) |
| Authorized Official Contact | 6192160111 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Eastlake Implant & Laser Dentistry 890 Eastlake Pkwy Suite 303 Chula Vista CA 91914-4520 Ph: (619) 216-0111 | Eastlake Implant & Laser Dentistry 890 Eastlake Pkwy Suite 303 Chula Vista CA 91914-4520 Ph: (619) 216-0111 |
| NPI Number | 1821223934 |
|---|---|
| Provider Enumeration Date | 05/18/2009 |
| Last Update Date | 08/04/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1821223934 | NPI | - | NPPES |
| 1922157288 | Other | CA | NPI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | 44306 (California) | Primary |
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