Southwest Dental Group | |
1502 S La Brucherie Rd El Centro CA 92243-9495 | |
(760) 482-5505 | |
(760) 482-5501 |
Full Name | Southwest Dental Group |
---|---|
Speciality | Dentist - Dental Public Health |
Location | 1502 S La Brucherie Rd, El Centro, California |
Authorized Official Name and Position | Javad Sage Aghaloo (OWNER) |
Authorized Official Contact | 7604825505 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Southwest Dental Group 1502 S La Brucherie Rd El Centro CA 92243-9495 Ph: (760) 482-5505 | Southwest Dental Group 1502 S La Brucherie Rd El Centro CA 92243-9495 Ph: (760) 482-5505 |
NPI Number | 1245606789 |
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Provider Enumeration Date | 08/19/2015 |
Last Update Date | 01/15/2016 |
Identifier | Type | State | Issuer |
---|---|---|---|
1245606789 | NPI | - | NPPES |
1245606789 | Other | CA | DENTICAL |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
1223D0001X | Dentist - Dental Public Health | 51184 (California) | Primary |
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