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General NPI Number Information
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NPI Number | 1891957171
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Entity Type | Organization
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Legal Business Name | S.D. DENTAL GROUP, INC
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Dates
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Enumeration Date | 06/27/2008
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Last Update Date | 03/31/2018
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Provider Practice Location Address
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Address Line | 6386 ALVARADO CT STE 315
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City | SAN DIEGO
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State | CA
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Zip | 92120-4908
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Country | US
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Telephone | 619-286-4122
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Fax |
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Provider Business Mailing Address
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Address Line | 6386 ALVARADO CT STE 315
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City | SAN DIEGO
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State | CA
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Zip | 92120-4908
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Country | US
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Telephone | 619-286-4122
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. STEVEN T. DANNEY
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Credential | D.D.S.
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Telephone | 619-286-4122
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number | 27117
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License Number State | CA
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