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General NPI Number Information
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NPI Number | 1861065245
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Entity Type | Organization
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Legal Business Name | AILEEN LABAN ARCE DENTAL CORPORATION
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Dates
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Enumeration Date | 07/22/2021
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Last Update Date | 04/20/2023
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Provider Practice Location Address
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Address Line | 1072 3RD AVE STE A
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City | CHULA VISTA
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State | CA
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Zip | 91911-2085
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Country | US
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Telephone | 619-425-5323
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Fax |
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Provider Business Mailing Address
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Address Line | 1072 3RD AVE STE A
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City | CHULA VISTA
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State | CA
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Zip | 91911-2085
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Country | US
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Telephone | 619-425-5323
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Fax |
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | DANIELA BUTLER
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Credential |
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Telephone | 619-301-1260
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number |
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License Number State |
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