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NPI Code Detail

MEDICARE: THE DENTAL OFFICES OF DR MCMAHAN DDS AND DR ROSELL DDS INC

MEDICARE: THE DENTAL OFFICES OF DR MCMAHAN DDS AND DR ROSELL DDS INC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11223G0001XGeneral Practice Dentistry37282CA
21223G0001XGeneral Practice Dentistry37872CA

General Provider Information

NPI Number : 1376638296
Entity Type Code : Organization
Provider Name (Legal Business Name) : THE DENTAL OFFICES OF DR MCMAHAN DDS AND DR ROSELL DDS INC
Provider Business Mailing Address
First Line : 2420 VISTA WAY
Second Line : SUITE 100
City : OCEANSIDE
State : CA
Zip : 92054-6190
Country : US
Telephone Number : 760-721-1022
Fax Number : 760-721-1431
Provider Business Practice Location Address
First Line : 2420 VISTA WAY
Second Line : SUITE 100
City : OCEANSIDE
State : CA
Zip : 92054-6190
Country : US
Telephone Number : 760-721-1022
Fax Number : 760-721-1431
Authorized Official
Title or Position : OFFICE MANAGER
Name : MRS. MARY GONZALES
Credential :
Telephone Number : 760-721-1022
Provider Enumeration Date : 10/04/2006
Last Update Date : 03/13/2008

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Directions to “THE DENTAL OFFICES OF DR MCMAHAN DDS AND DR ROSELL DDS INC ” Practice Location

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