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2648 Jamacha Rd Suite 166 El Cajon CA 92019-4346 | |
| (619) 670-5571 | |
| (619) 670-5592 |
| Full Name | |
|---|---|
| Speciality | Dentist - Dental Public Health |
| Location | 2648 Jamacha Rd, El Cajon, California |
| Authorized Official Name and Position | Joel B. Henriod (OWNER/PARTNERSHIP) |
| Authorized Official Contact | 6196705571 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
2648 Jamacha Rd Suite 166 El Cajon CA 92019-4346 Ph: (619) 670-5571 | 2648 Jamacha Rd Suite 166 El Cajon CA 92019-4346 Ph: (619) 670-5571 |
| NPI Number | 1306111976 |
|---|---|
| Provider Enumeration Date | 03/15/2012 |
| Last Update Date | 05/21/2019 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1306111976 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223D0001X | Dentist - Dental Public Health | 55124 (California) | Primary |
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