| Mary Ann V Sanvictores Dds Inc | |
|
600 Palm Avenue Suite 116 Imperial Beach CA 91932-1245 | |
| (619) 628-8123 | |
| (619) 628-8081 |
| Full Name | Mary Ann V Sanvictores Dds Inc |
|---|---|
| Speciality | Dentist |
| Location | 600 Palm Avenue, Imperial Beach, California |
| Authorized Official Name and Position | Mary Ann Vergara Sanvictores (DENTIST CEO) |
| Authorized Official Contact | 6196288123 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Mary Ann V Sanvictores Dds Inc 600 Palm Avenue Suite 116 Imperial Beach CA 91932-1245 Ph: (619) 628-8123 | Mary Ann V Sanvictores Dds Inc 600 Palm Avenue Suite 116 Imperial Beach CA 91932-1245 Ph: (619) 628-8123 |
| NPI Number | 1669480992 |
|---|---|
| Provider Enumeration Date | 08/03/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1669480992 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 44360 (California) | Primary |
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M Mallempalli Professional Dental Corporation Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 600 Palm Ave., Suite#116, Imperial Beach, CA 91932 Phone: 619-628-8123 | |
M Mallempalli Professional Dental Corporation Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 600 Palm Ave Ste 116, Imperial Beach, CA 91932 Phone: 619-628-8123 |