Organization
ESCONDIDO PEDIATRIC DENTISTRY, A DENTAL OFFICE OF DR. CHRISTIAN M FORT
Active
Other names
Escondido Pediatric Dentistry
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CHRISTIAN M FORTNEY CICCARELLA DDS (PRESIDENT)
(760) 317-9598
Entity
Organization
Contact information
Practice address
925 E PENNSYLVANIA AVE STE I, ESCONDIDO, CA 92025-3432
(760) 743-7176
Mailing address
925 E PENNSYLVANIA AVE STE I, ESCONDIDO, CA 92025-3432
(760) 743-7176
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
—
—
Other
Enumeration date
05/22/2019
Last updated
05/22/2019
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