Organization
BARSTOW FAMILY DENTAL
Active
Parent organization
BARSTOW FAMILY DENTAL
Organization subpart
Yes
Provider details
NPI number
Legal business name
BARSTOW FAMILY DENTAL
Authorized official
GREGORY ERIC OLAFSEN (D.D.S.)
(760) 256-1083
Entity
Organization
Contact information
Practice address
1940 E MAIN ST, BARSTOW, CA 92311-3218
(760) 256-1083
(760) 256-0079
Mailing address
1940 E MAIN ST, BARSTOW, CA 92311-3218
(760) 256-1083
(760) 256-0079
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
41202
CA
Other
Enumeration date
08/12/2009
Last updated
08/12/2009
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