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Organization
AVINA DENTAL CORPORATION
Active
Organization
AVINA DENTAL CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANASTASIA AVINA (PRESIDENT)
(858) 350-0337
Entity
Organization
Contact information
Practice address
12395 EL CAMINO REAL STE 101, SAN DIEGO, CA 92130-3083
(858) 350-0337
Mailing address
12395 EL CAMINO REAL STE 101, SAN DIEGO, CA 92130-3083
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
02/20/2020
Last updated
02/20/2020
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