| Tooth Fairy Dental Group | |
|
28350 Via Santa Rosa Temecula CA 92590-5335 | |
| (619) 259-4001 | |
| Not Available |
| Full Name | Tooth Fairy Dental Group |
|---|---|
| Speciality | Dentist |
| Location | 28350 Via Santa Rosa, Temecula, California |
| Authorized Official Name and Position | Nathaniel S Liu (PRESIDENT) |
| Authorized Official Contact | 6192594001 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Tooth Fairy Dental Group 1040 Tierra Del Rey Ste 103 Chula Vista CA 91910-7865 Ph: (619) 482-1210 | Tooth Fairy Dental Group 28350 Via Santa Rosa Temecula CA 92590-5335 Ph: (619) 259-4001 |
| NPI Number | 1962658690 |
|---|---|
| Provider Enumeration Date | 08/13/2008 |
| Last Update Date | 07/21/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1962658690 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | D44924 (California) | Primary |
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