Organization
DIXON ORTHODONTIC DENTAL GROUP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MAY CAMACHO RDA (OFFICE MANAGER)
(858) 455-9171
Entity
Organization
Contact information
Practice address
5627 OBERLIN DR STE 100, SAN DIEGO, CA 92121-3748
(858) 455-9171
Mailing address
5627 OBERLIN DR STE 100, SAN DIEGO, CA 92121-3748
(858) 455-9171
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
33593
CA
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
46565
CA
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
47565
CA
Other
Enumeration date
03/14/2016
Last updated
03/14/2016
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