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Organization
FEDOR DENTAL CORPORATION
Active
Organization
FEDOR DENTAL CORPORATION
Active
Other names
Serra Mesa Modern Dentistry Dental Group
Organization subpart
No
Provider details
NPI number
Authorized official
GRACE C FEDOR DDS (OWNER)
(858) 617-0620
Entity
Organization
Contact information
Practice address
3268 GREYLING DR, SAN DIEGO, CA 92123
(858) 617-0620
Mailing address
PO BOX 920050, DALLAS, TX 75392-0050
(714) 845-8890
(303) 952-0892
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
—
Other
Enumeration date
08/02/2018
Last updated
03/08/2022
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