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3605 Alamo St Ste 210 Simi Valley CA 93063-2186 | |
| (805) 583-1799 | |
| (805) 583-1790 |
| Full Name | |
|---|---|
| Speciality | Dentist - Endodontics |
| Location | 3605 Alamo St Ste 210, Simi Valley, California |
| Authorized Official Name and Position | Marie Deweese (OFFICE MANAGER) |
| Authorized Official Contact | 8055831799 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
3605 Alamo St Ste 210 Simi Valley CA 93063-2186 Ph: (805) 583-1799 | 3605 Alamo St Ste 210 Simi Valley CA 93063-2186 Ph: (805) 583-1799 |
| NPI Number | 1699935643 |
|---|---|
| Provider Enumeration Date | 06/12/2008 |
| Last Update Date | 06/12/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1699935643 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223E0200X | Dentist - Endodontics | 44763 (California) | Primary |
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