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NPI Code Detail

MEDICARE: ALVARADO DENTAL GROUP

MEDICARE: ALVARADO DENTAL GROUP
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 Dentistry29790CA
21223G0001XGeneral Practice Dentistry29858CA

General Provider Information

NPI Number : 1619118254
Entity Type Code : Organization
Provider Name (Legal Business Name) : ALVARADO DENTAL GROUP
Provider Business Mailing Address
First Line : 6475 ALVARADO RD STE 205
Second Line :
City : SAN DIEGO
State : CA
Zip : 92120-5013
Country : US
Telephone Number : 619-287-0990
Fax Number : 619-287-1462
Provider Business Practice Location Address
First Line : 6475 ALVARADO RD STE 205
Second Line :
City : SAN DIEGO
State : CA
Zip : 92120-5013
Country : US
Telephone Number : 619-287-0990
Fax Number : 619-287-1462
Authorized Official
Title or Position : DENTIST
Name : DR. DANIEL PERRY
Credential : D.D.S.
Telephone Number : 619-287-0990
Provider Enumeration Date : 03/11/2009
Last Update Date : 03/11/2009

Similar Medicare Providers

1356312383 — SUSAN PATRICIA MUNSEY L.C.S.W.
Practice Location Address:
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Directions to “ALVARADO DENTAL GROUP ” Practice Location

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