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General NPI Number Information
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NPI Number | 1649489998
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Entity Type | Organization
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Legal Business Name | DMV DENTAL, INC
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Dates
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Enumeration Date | 05/22/2007
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Last Update Date | 01/07/2016
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Provider Practice Location Address
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Address Line | 1035 HIGHLAND AVE
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City | NATIONAL CITY
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State | CA
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Zip | 91950
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Country | US
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Telephone | 619-477-0888
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Fax | 619-477-6888
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Provider Business Mailing Address
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Address Line | 1035 HIGHLAND AVE
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City | NATIONAL CITY
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State | CA
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Zip | 91950
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Country | US
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Telephone | 619-477-0888
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Fax | 619-477-6888
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Authorized Official
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Title or Position | PRES OF CORP CEO DENTIST
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Name | DR. DINAH MAULAWIN VITUG
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Credential | DDS
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Telephone | 619-477-0888
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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 | 49238
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License Number State | CA
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