Individual
DENISSE PATRICIA MACIAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
235 EAST ORANGE AVENUE, APARTMENT E4, CHULA VISTA, CA 91911
(619) 763-8258
Mailing address
3975 CAMINO DE LA PLZ, STE 208 #1292, SAN YSIDRO, CA 92173
(619) 763-8258
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
104574
CA
1223G0001X
General Practice Dentistry
104574
CA
Other
Enumeration date
12/16/2019
Last updated
12/16/2019
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