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Organization
OSCAR A BRACAMONTES DDS
Active
Organization
OSCAR A BRACAMONTES DDS
Active
Other names
Dr Oscar A Bracamontes
Organization subpart
No
Provider details
NPI number
Authorized official
DR. OSCAR A BRACAMONTES DDS (OWNER)
(619) 946-1071
Entity
Organization
Contact information
Practice address
1144 13TH ST, SUITE 102, IMPERIAL BEACH, CA 91932-3675
(619) 946-1071
Mailing address
PO BOX 999, IMPERIAL BEACH, CA 91933-0999
(619) 778-6765
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
2763785
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2763785
LICENSE NUMBER
CA
Enumeration date
08/23/2016
Last updated
08/23/2016
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