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Organization
GEORGE R BRAITHWAITE
Active
Organization
GEORGE R BRAITHWAITE
Active
Other names
FAMILY DENTAL
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GEORGE R BRAITHWAITE D.M.D (DENTIST/PRESIDENT)
(760) 724-6537
Entity
Organization
Contact information
Practice address
630 ALTA VISTA DR, #108, VISTA, CA 92084-5504
(760) 724-6537
(760) 724-5115
Mailing address
630 ALTA VISTA DR, #108, VISTA, CA 92084-5504
(760) 724-6537
(760) 724-5115
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
24937
CA
Other
Enumeration date
09/25/2007
Last updated
07/27/2011
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