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Organization
MARY ANN V SANVICTORES DDS INC
Active
Organization
MARY ANN V SANVICTORES DDS INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. MARY ANN VERGARA SANVICTORES DDS (DENTIST CEO)
(619) 628-8123
Entity
Organization
Contact information
Practice address
600 PALM AVENUE, SUITE 116, IMPERIAL BEACH, CA 91932-1245
(619) 628-8123
(619) 628-8081
Mailing address
600 PALM AVENUE, SUITE 116, IMPERIAL BEACH, CA 91932-1245
(619) 628-8123
(619) 628-8081
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
44360
CA
Other
Enumeration date
08/03/2006
Last updated
08/22/2020
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