Individual
MR. CARLOS SANTANA MONTALVO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
IDC
Contact information
Practice address
2700 ADAMS AVE STE 209, SAN DIEGO, CA 92116-1367
(619) 647-4599
(888) 323-3119
Mailing address
2700 ADAMS AVE STE 209, SAN DIEGO, CA 92116-1367
(619) 647-4599
(888) 323-3119
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
31862
CA
1710I1002X
Independent Duty Corpsman
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
31862
BOARD OF DENTAL HYGIENE CALIFORNIA
CA
Enumeration date
05/15/2007
Last updated
11/07/2022
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