| San Diego Dental Anesthesia | |
|
1287 Carlsbad Village Drive Carlsbad CA 92008 | |
| (619) 339-0760 | |
| Not Available |
| Full Name | San Diego Dental Anesthesia |
|---|---|
| Speciality | Dentist - Dentist Anesthesiologist |
| Location | 1287 Carlsbad Village Drive, Carlsbad, California |
| Authorized Official Name and Position | Tyler Johnson (PRESIDENT) |
| Authorized Official Contact | 6193390760 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| San Diego Dental Anesthesia 8677 Villa La Jolla Dr # 1255 La Jolla CA 92037-2354 Ph: (619) 339-0760 | San Diego Dental Anesthesia 1287 Carlsbad Village Drive Carlsbad CA 92008 Ph: (619) 339-0760 |
| NPI Number | 1710548375 |
|---|---|
| Provider Enumeration Date | 06/25/2019 |
| Last Update Date | 06/25/2019 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1710548375 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223D0004X | Dentist - Dentist Anesthesiologist | (* (Not Available)) | Primary |
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