# MISSION VALLEY ORAL & MAXILLOFACIAL SURGERY, INC.

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1265767644
- **Authorized official:** DR. FREDERICK WHITE HAMMOND DDS (PARTNER)
- **Authorized official phone:** (619) 298-2200

## Contact information

- **Practice address:** 2878 CAMINO DEL RIO S, SUITE 210, SAN DIEGO, CA 92108-3872
- **Practice address phone:** (619) 298-2200
- **Practice address fax:** (619) 298-2250
- **Mailing address:** 2878 CAMINO DEL RIO S, SUITE 210, SAN DIEGO, CA 92108-3872
- **Mailing address phone:** (619) 298-2200
- **Mailing address fax:** (619) 298-2250

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | 31922 | CA | Yes |

## Other

- **Enumeration date:** 10/02/2009
- **Last updated:** 10/02/2009