Organization
DR. PERIKLIS PROUSSAEFS, A PROFESSIONAL DENTAL CORPORATION
Active
Other names
Santa Paula Dental Group
Organization subpart
No
Provider details
NPI number
Authorized official
DR. PERIKLIS PROUSSAEFS DDS, MS (OWNER/CEO/CLINIC DIRECTOR)
(805) 676-1611
Entity
Organization
Contact information
Practice address
900 EAST MAIN STREET, SANTA PAULA, CA 93060
(805) 676-1611
(805) 676-1521
Mailing address
900 EAST MAIN STREET, SANTA PAULA, CA 93060
(805) 676-1611
(805) 676-1521
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
—
Other
Enumeration date
10/17/2018
Last updated
10/17/2018
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