Individual
DR. MARCELO FREIRE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.,PH.D., D.MED.
Contact information
Practice address
4120 CAPRICORN LN, LA JOLLA, CA 92037-3498
(858) 200-1846
Mailing address
4120 CAPRICORN LN, LA JOLLA, CA 92037-3498
(858) 200-1846
Taxonomy
Speciality
Code
Description
License number
State
1223P0300X
Periodontics
Primary
103604
CA
390200000X
Student in an Organized Health Care Education/Training Program
DL11672
MA
Other
Enumeration date
08/06/2012
Last updated
11/29/2022
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