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Organization
INTERNATIONAL DENTAL PROVIDERS CORP.
Active
Organization
INTERNATIONAL DENTAL PROVIDERS CORP.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ANGEL SERRANO DDS (OWNER)
(619) 691-8180
Entity
Organization
Contact information
Practice address
1594 WOODLARK CT, CHULA VISTA, CA 91911-5321
(619) 691-8180
(619) 691-1201
Mailing address
1594 WOODLARK CT, CHULA VISTA, CA 91911-5321
(619) 691-8180
(619) 691-1201
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
512443
ZZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
104
DENTAL HEALTH SERVICES OF CALIFORNIA
CA
01
—
1141
SAFEGUARD HEALTH PLANS, INC.
CA
01
—
1185
GOLDEN WEST HEALTH PLANS, INC
CA
01
—
1327
CALIFORNIA DENTAL NETWORK, INC
CA
01
—
1369
WESTERN DENTAL SERVICES, INC
CA
01
—
325977
PACIFIC UNION DENTAL, INC
CA
01
—
351398
UNITED CONCORDIA DENTAL PLANS OF CALIFORNIA, INC
CA
01
—
4048
LIBERTY DENTAL PLANS OF CALIFORNIA
CA
01
—
44010
PACIFICARE DENTAL & VISION ADMINISTRATORS
CA
Enumeration date
08/11/2008
Last updated
08/11/2008
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