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Organization
SMILE COMMUNITY CLINIC INC
Active
Organization
SMILE COMMUNITY CLINIC INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
VIDA NAMAVAR DDS (OFFICER)
(760) 471-9292
Entity
Organization
Contact information
Practice address
670 W. SAN MARCOS BLVD. STE 103-B, SAN MARCOS, CA 92078
(760) 471-9292
(760) 471-9293
Mailing address
670 W. SAN MARCOS BLVD STE 103-B, SAN MARCOS, CA 92078
(760) 471-9292
(760) 471-9293
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
59394
CA
Other
Enumeration date
08/29/2017
Last updated
08/29/2017
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