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Organization
MIYAMOTO AND PHI DENTAL CORPORATION
Active
Organization
MIYAMOTO AND PHI DENTAL CORPORATION
Active
Other names
La Jolla Del Sur Dental
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GERALD MIYAMOTO D.D.S. (CEO)
(858) 454-5822
Entity
Organization
Contact information
Practice address
470 NAUTILUS ST, SUITE 309, LA JOLLA, CA 92037-5969
(858) 454-5822
Mailing address
470 NAUTILUS ST, SUITE 309, LA JOLLA, CA 92037-5969
(858) 454-5822
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
47291
CA
Other
Enumeration date
05/18/2007
Last updated
08/22/2020
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