| La Costa Del Sur Dental Practice | |
|
3257 Camino De Los Coches Suite 302 Carlsbad CA 92009-8966 | |
| (760) 942-5888 | |
| Not Available |
| Full Name | La Costa Del Sur Dental Practice |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 3257 Camino De Los Coches, Carlsbad, California |
| Authorized Official Name and Position | Gerald Miyamoto (PRESIDENT) |
| Authorized Official Contact | 7609425888 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| La Costa Del Sur Dental Practice 3257 Camino De Los Coches Suite 302 Carlsbad CA 92009-8966 Ph: () - | La Costa Del Sur Dental Practice 3257 Camino De Los Coches Suite 302 Carlsbad CA 92009-8966 Ph: (760) 942-5888 |
| NPI Number | 1508075086 |
|---|---|
| Provider Enumeration Date | 05/22/2007 |
| Last Update Date | 02/19/2009 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1508075086 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 47291 (California) | Primary |
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