| Lighthouse Dental | |
|
3625 Midway Dr Ste A San Diego CA 92110-5253 | |
| (619) 224-2204 | |
| Not Available |
| Full Name | Lighthouse Dental |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 3625 Midway Dr Ste A, San Diego, California |
| Authorized Official Name and Position | Ajay Dilip Amin (PRESIDENT) |
| Authorized Official Contact | 6192242204 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Lighthouse Dental 11760 Carmel Creek Rd Apt 305 San Diego CA 92130-6612 Ph: (951) 756-9019 | Lighthouse Dental 3625 Midway Dr Ste A San Diego CA 92110-5253 Ph: (619) 224-2204 |
| NPI Number | 1275003048 |
|---|---|
| Provider Enumeration Date | 12/05/2018 |
| Last Update Date | 01/23/2019 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1275003048 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | (* (Not Available)) | Primary |
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