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Organization
MARISA PODESTO DDS, DENTAL CORPORATION
Active
Organization
MARISA PODESTO DDS, DENTAL CORPORATION
Active
Other names
Bonita Dental Center
Organization subpart
No
Provider details
NPI number
Authorized official
TODD LUDDEN DDS (ASSOCIATE)
(619) 267-2115
Entity
Organization
Contact information
Practice address
5050 BONITA RD, BONITA, CA 91902-1701
(619) 267-2115
(619) 354-4166
Mailing address
5050 BONITA RD, BONITA, CA 91902-1701
(619) 267-2115
(619) 354-4166
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
61894
CA
Other
Enumeration date
01/03/2018
Last updated
11/12/2019
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