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General NPI Number Information
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NPI Number | 1871633172
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Entity Type | Organization
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Legal Business Name | MISAKO HIROTA DMD A DENTAL CORPORATION
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Dates
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Enumeration Date | 02/07/2007
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Last Update Date | 08/06/2009
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Provider Practice Location Address
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Address Line | 219 E 8TH ST
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City | NATIONAL CITY
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State | CA
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Zip | 91950-2224
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Country | US
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Telephone | 619-474-4695
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Fax | 619-474-2984
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Provider Business Mailing Address
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Address Line | 219 E 8TH ST
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City | NATIONAL CITY
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State | CA
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Zip | 91950-2224
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Country | US
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Telephone | 619-474-4695
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Fax | 619-474-2984
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Authorized Official
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Title or Position | OWNER PRESIDENT
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Name | DR. MISAKO HIROTA
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Credential | DMD
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Telephone | 619-474-4695
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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 | DE35117
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License Number State | CA
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