| |
706 Townsite Dr Vista CA 92084-4502 | |
(760) 724-4392 | |
(760) 724-4344 |
Full Name | |
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Speciality | Dentist - General Practice |
Location | 706 Townsite Dr, Vista, California |
Authorized Official Name and Position | Sergio Ayala (DDS) |
Authorized Official Contact | 6195817107 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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706 Townsite Dr Vista CA 92084-4502 Ph: (760) 724-4392 | 706 Townsite Dr Vista CA 92084-4502 Ph: (760) 724-4392 |
NPI Number | 1184298689 |
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Provider Enumeration Date | 05/18/2021 |
Last Update Date | 11/24/2021 |
Identifier | Type | State | Issuer |
---|---|---|---|
1184298689 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
122300000X | Dentist | (* (Not Available)) | Secondary |
1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
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