| Petros.toma&putrus Dental Corp | |
|
4844 University Ave Suite B San Diego CA 92105-8021 | |
| (619) 285-5010 | |
| (619) 285-5013 |
| Full Name | Petros.toma&putrus Dental Corp |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 4844 University Ave, San Diego, California |
| Authorized Official Name and Position | Dhafir J Petros (DENTIST) |
| Authorized Official Contact | 6192855010 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Petros.toma&putrus Dental Corp 4844 University Ave Suite B San Diego CA 92105-8021 Ph: (619) 285-5010 | Petros.toma&putrus Dental Corp 4844 University Ave Suite B San Diego CA 92105-8021 Ph: (619) 285-5010 |
| NPI Number | 1548320849 |
|---|---|
| Provider Enumeration Date | 12/10/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1548320849 | NPI | - | NPPES |
| D47154 | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 47154 (California) | Primary |
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