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General NPI Number Information
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NPI Number | 1548667470
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Entity Type | Organization
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Legal Business Name | MARITESSA I. MASANGYA DDS, INC.
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Dates
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Enumeration Date | 11/20/2014
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Last Update Date | 11/20/2014
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Provider Practice Location Address
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Address Line | 2207 HIGHLAND AVE. SUITE 102
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City | NATIONAL CITY
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State | CA
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Zip | 91950-6905
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Country | US
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Telephone | 619-292-2996
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Fax | 619-292-2571
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Provider Business Mailing Address
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Address Line | 2207 HIGHLAND AVE. SUITE 102
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City | NATIONAL CITY
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State | CA
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Zip | 91950-6905
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Country | US
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Telephone | 619-292-2996
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Fax | 619-292-2571
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Authorized Official
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Title or Position | DDS/OWNER
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Name | DR. MARITESSA MENDOZA MASANGYA
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Credential |
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Telephone | 619-292-2996
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 47946
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License Number State | CA
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