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Organization
A. DOMINGUEZ DDS PROFESSIONAL DENTAL CORPORATION
Active
Organization
A. DOMINGUEZ DDS PROFESSIONAL DENTAL CORPORATION
Active
Other names
AD Dental
Organization subpart
No
Provider details
NPI number
Authorized official
NICOLE REID (BUSINESS MANAGER)
(619) 691-0121
Entity
Organization
Contact information
Practice address
290 LANDIS AVE, STE A&B, CHULA VISTA, CA 91910-2636
(619) 691-0121
Mailing address
290 LANDIS AVE, STE A&B, CHULA VISTA, CA 91910-2636
(619) 691-0121
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
50595
CA
Other
Enumeration date
01/12/2016
Last updated
01/12/2016
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