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Organization
G. MARQUEZ, D.D.S., INC
Active
Organization
G. MARQUEZ, D.D.S., INC
Active
Other names
Otay Lakes Smiles
Organization subpart
No
Provider details
NPI number
Authorized official
GUADALUPE MARQUEZ D.D.S. (PRESIDENT)
(619) 934-6620
Entity
Organization
Contact information
Practice address
2452 FENTON STREET, SUITE C-200, CHULA VISTA, CA 91914
(619) 934-6620
(619) 934-4503
Mailing address
2452 FENTON STREET, SUITE C-200, CHULA VISTA, CA 91914
(619) 934-6620
(619) 934-4503
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
38716
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
B38716-01
DENTICAL
CA
Enumeration date
06/05/2007
Last updated
08/16/2007
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