| School Base Program | |
|
4100 Normal St San Diego CA 92103-2653 | |
| (619) 234-8131 | |
| (619) 234-0048 |
| Full Name | School Base Program |
|---|---|
| Speciality | Dentist |
| Location | 4100 Normal St, San Diego, California |
| Authorized Official Name and Position | Mariluci C Byrnes (DIRECTOR OF GENERAL DENTISTRY) |
| Authorized Official Contact | 6192348131 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| School Base Program 1270 24th Street San Diego CA 92102-2012 Ph: (619) 234-8131 | School Base Program 4100 Normal St San Diego CA 92103-2653 Ph: (619) 234-8131 |
| NPI Number | 1447455381 |
|---|---|
| Provider Enumeration Date | 06/20/2007 |
| Last Update Date | 05/23/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1447455381 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | (* (Not Available)) | Primary |
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