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Organization
DUFFY C. DE GRAW D.D.S. A PROFESSIONAL CORPORATION
Active
Organization
DUFFY C. DE GRAW D.D.S. A PROFESSIONAL CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DUFFY CHARLES DE GRAW D.D.S. (CEO)
(805) 528-3000
Entity
Organization
Contact information
Practice address
2238 BAYVIEW HEIGHTS DR STE F, LOS OSOS, CA 93402-3932
(805) 528-3000
(805) 528-3080
Mailing address
2238 BAYVIEW HEIGHTS DR STE F, LOS OSOS, CA 93402-3932
(805) 528-3000
(805) 528-3080
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
57262
CA
Other
Enumeration date
11/16/2011
Last updated
11/16/2011
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