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742 Broadway El Cajon CA 92021-4630 | |
| (619) 440-0071 | |
| (619) 440-0719 |
| Full Name | |
|---|---|
| Speciality | Dentist |
| Location | 742 Broadway, El Cajon, California |
| Authorized Official Name and Position | Anthony Philip Garofalo (PRESIDENT) |
| Authorized Official Contact | 6194400071 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
742 Broadway El Cajon CA 92021-4630 Ph: (619) 440-0071 | 742 Broadway El Cajon CA 92021-4630 Ph: (619) 440-0071 |
| NPI Number | 1114143310 |
|---|---|
| Provider Enumeration Date | 04/17/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1114143310 | NPI | - | NPPES |
| B25709 | Other | CA | DENTICAL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 25709 (California) | Primary |
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