Healthcare Provider Details

I. General information

NPI: 1588658827
Provider Name (Legal Business Name): PRESTON CHARLES BRIGGS DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 09/01/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1ST DENTAL BATALLION CAMP PENDLETON
OCEANSIDE CA
92054
US

IV. Provider business mailing address

999 N PACIFIC ST
OCEANSIDE CA
92054-2056
US

V. Phone/Fax

Practice location:
  • Phone: 760-725-2569
  • Fax:
Mailing address:
  • Phone: 949-201-6590
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number49474
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: