# A. DOMINGUEZ DDS PROFESSIONAL DENTAL CORPORATION

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- **Entity:** Organization
- **Status:** Active
- **Other names:** AD Dental
- **Organization subpart:** No

## Provider details

- **NPI number:** 1013373620
- **Authorized official:** NICOLE REID (BUSINESS MANAGER)
- **Authorized official phone:** (619) 691-0121

## Contact information

- **Practice address:** 290 LANDIS AVE, STE A&B, CHULA VISTA, CA 91910-2636
- **Practice address phone:** (619) 691-0121
- **Mailing address:** 290 LANDIS AVE, STE A&B, CHULA VISTA, CA 91910-2636
- **Mailing address phone:** (619) 691-0121

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | 50595 | CA | Yes |

## Other

- **Enumeration date:** 01/12/2016
- **Last updated:** 01/12/2016