| Eastlake Periodontics And Implants | |
|
2452 Fenton St Suite 302 Chula Vista CA 91914-3516 | |
| (619) 482-3205 | |
| (619) 482-3206 |
| Full Name | Eastlake Periodontics And Implants |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 2452 Fenton St, Chula Vista, California |
| Authorized Official Name and Position | Scott Tadashi Ozaki (OWNER) |
| Authorized Official Contact | 6194823205 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Eastlake Periodontics And Implants 2452 Fenton St Suite 302 Chula Vista CA 91914-3516 Ph: (619) 482-3205 | Eastlake Periodontics And Implants 2452 Fenton St Suite 302 Chula Vista CA 91914-3516 Ph: (619) 482-3205 |
| NPI Number | 1376738062 |
|---|---|
| Provider Enumeration Date | 09/06/2007 |
| Last Update Date | 09/06/2007 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1376738062 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | 41977 (California) | Primary |
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