Healthcare Provider Details
I. General information
NPI: 1902455884
Provider Name (Legal Business Name): AILEEN ARCE DDS INCORPORATED
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 09/04/2019
Last Update Date: 04/20/2023
Certification Date: 04/20/2023
Deactivation Date:
Reactivation Date:
III. Provider practice location address
345 F ST STE 140
CHULA VISTA CA
91910-2632
US
IV. Provider business mailing address
345 F ST STE 140
CHULA VISTA CA
91910-2632
US
V. Phone/Fax
- Phone: 619-240-3829
- Fax:
- Phone: 619-240-3829
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 1223D0001X |
| Taxonomy | Public Health Dentistry |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: MRS.
DANIELA
BUTLER
Title or Position: OFFICE MANAGER
Credential:
Phone: 619-301-1260