Healthcare Provider Details

I. General information

NPI: 1497501431
Provider Name (Legal Business Name): DOWDY DENTAL ANESTHESIA GROUP, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/29/2024
Last Update Date: 11/26/2024
Certification Date: 11/26/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

110 TOWN CENTER PKWY STE B
SANTEE CA
92071-5801
US

IV. Provider business mailing address

1018 HAYES AVE
SAN DIEGO CA
92103-2309
US

V. Phone/Fax

Practice location:
  • Phone: 619-937-1012
  • Fax:
Mailing address:
  • Phone: 619-937-1012
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223D0004X
TaxonomyDental Anesthesiology
License Number
License Number State

VIII. Authorized Official

Name: REGINA DOWDY
Title or Position: OWNER
Credential: DDS
Phone: 619-937-1012