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Organization
BEATRIZ VIDALES DDS, INC
Active
Organization
BEATRIZ VIDALES DDS, INC
Active
Parent organization
BEATRIZ VIDALES DDS, INC.
Other names
Dental Familiar & Ortho
Organization subpart
Yes
Provider details
NPI number
Legal business name
BEATRIZ VIDALES DDS, INC.
Authorized official
DR. BEATRIZ VIDALES DDS (DENTAL DIRECTOR)
(760) 743-6790
Entity
Organization
Contact information
Practice address
725 N QUINCE ST, 101, ESCONDIDO, CA 92025-1680
(760) 743-6790
(760) 743-2874
Mailing address
725 N QUINCE ST, 101, ESCONDIDO, CA 92025-1680
(760) 743-6790
(760) 743-2874
Taxonomy
Speciality
Code
Description
License number
State
305R00000X
Preferred Provider Organization
Primary
45212
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
45212
DENTAL LICENCE
CA
01
—
B4521201
DENTI-CAL ID NUM
CA
Enumeration date
08/31/2006
Last updated
09/27/2013
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