Organization
A. DOMINGUEZ DDS PROFESSIONAL DENTAL CORPORATION
Active
Other names
AD Dental
Organization subpart
No
Provider details
NPI number
Authorized official
NICOLE REID (BUSINESS MANAGER)
(619) 691-0121
Entity
Organization
Contact information
Practice address
290 LANDIS AVE, STE A&B, CHULA VISTA, CA 91910-2636
(619) 691-0121
Mailing address
290 LANDIS AVE, STE A&B, CHULA VISTA, CA 91910-2636
(619) 691-0121
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
50595
CA
Other
Enumeration date
01/12/2016
Last updated
01/12/2016
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