| Serra Mesa Modern Dentistry Dental Group | |
|
3268 Greyling Dr San Diego CA 92123 | |
| (858) 617-0620 | |
| Not Available |
| Full Name | Serra Mesa Modern Dentistry Dental Group |
|---|---|
| Speciality | Dentist |
| Location | 3268 Greyling Dr, San Diego, California |
| Authorized Official Name and Position | Grace C Fedor (OWNER) |
| Authorized Official Contact | 8586170620 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Serra Mesa Modern Dentistry Dental Group Po Box 920050 Dallas TX 75392-0050 Ph: (714) 845-8890 | Serra Mesa Modern Dentistry Dental Group 3268 Greyling Dr San Diego CA 92123 Ph: (858) 617-0620 |
| NPI Number | 1871071795 |
|---|---|
| Provider Enumeration Date | 08/02/2018 |
| Last Update Date | 03/08/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1871071795 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | (* (Not Available)) | Primary |
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