| Mission Valley Oral & Maxillofacial Surgery, Inc. | |
|
2878 Camino Del Rio S Suite 210 San Diego CA 92108-3872 | |
| (619) 298-2200 | |
| (619) 298-2250 |
| Full Name | Mission Valley Oral & Maxillofacial Surgery, Inc. |
|---|---|
| Speciality | Dentist - Oral And Maxillofacial Surgery |
| Location | 2878 Camino Del Rio S, San Diego, California |
| Authorized Official Name and Position | Frederick White Hammond (PARTNER) |
| Authorized Official Contact | 6192982200 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Mission Valley Oral & Maxillofacial Surgery, Inc. 2878 Camino Del Rio S Suite 210 San Diego CA 92108-3872 Ph: (619) 298-2200 | Mission Valley Oral & Maxillofacial Surgery, Inc. 2878 Camino Del Rio S Suite 210 San Diego CA 92108-3872 Ph: (619) 298-2200 |
| NPI Number | 1265767644 |
|---|---|
| Provider Enumeration Date | 10/02/2009 |
| Last Update Date | 10/02/2009 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1265767644 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223S0112X | Dentist - Oral And Maxillofacial Surgery | 31922 (California) | Primary |
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