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Organization
LAJOLLA COSMETIC & FAMILY DENTISTRY INC
Active
Organization
LAJOLLA COSMETIC & FAMILY DENTISTRY INC
Active
Parent organization
LAJOLLA COSMETIC & FAMILY DENTISTRY INC
Organization subpart
Yes
Provider details
NPI number
Legal business name
LAJOLLA COSMETIC & FAMILY DENTISTRY INC
Authorized official
NICK PAVLOV DDS (DENTIST)
(858) 459-5591
Entity
Organization
Contact information
Practice address
470 NAUTILUS ST, # 212, LA JOLLA, CA 92037
(858) 459-5591
(858) 459-4242
Mailing address
470 NAUTILUS ST, # 212, LA JOLLA, CA 92037
(858) 459-5591
(858) 459-4242
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
44055
CA
261QD0000X
Dental Clinic/Center
44055
CA
Other
Enumeration date
08/08/2007
Last updated
05/28/2008
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