| Escondido Pediatric Dentistry, A Dental Office Of Dr. Christian M Fort | |
|
925 E Pennsylvania Ave Ste I Escondido CA 92025-3432 | |
| (760) 743-7176 | |
| Not Available |
| Full Name | Escondido Pediatric Dentistry, A Dental Office Of Dr. Christian M Fort |
|---|---|
| Speciality | Dentist - Pediatric Dentistry |
| Location | 925 E Pennsylvania Ave Ste I, Escondido, California |
| Authorized Official Name and Position | Christian M Fortney Ciccarella (PRESIDENT) |
| Authorized Official Contact | 7603179598 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Escondido Pediatric Dentistry, A Dental Office Of Dr. Christian M Fort 925 E Pennsylvania Ave Ste I Escondido CA 92025-3432 Ph: (760) 743-7176 | Escondido Pediatric Dentistry, A Dental Office Of Dr. Christian M Fort 925 E Pennsylvania Ave Ste I Escondido CA 92025-3432 Ph: (760) 743-7176 |
| NPI Number | 1093372351 |
|---|---|
| Provider Enumeration Date | 05/22/2019 |
| Last Update Date | 05/22/2019 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1093372351 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0221X | Dentist - Pediatric Dentistry | (* (Not Available)) | Primary |
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