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General NPI Number Information
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NPI Number | 1629928239
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Entity Type | Organization
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Legal Business Name | I ZAK DDS PROF DENTAL CORP
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Dates
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Enumeration Date | 02/02/2026
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Last Update Date | 02/02/2026
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Provider Practice Location Address
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Address Line | 275 W MADISON AVE STE B
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City | EL CAJON
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State | CA
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Zip | 92020-3458
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Country | US
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Telephone | 619-588-2420
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Fax |
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Provider Business Mailing Address
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Address Line | 275 W MADISON AVE STE B
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City | EL CAJON
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State | CA
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Zip | 92020-3458
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Country | US
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Telephone | 619-588-2420
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Fax |
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Authorized Official
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Title or Position | DIRECTOR OF RCMC
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Name | MARIA ALEJANDRA RODRIGUEZ
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Credential |
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Telephone | 661-292-9241
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223D0001X
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Taxonomy Name | Public Health Dentistry
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License Number |
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License Number State |
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