Individual
BENJAMIN STALLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
34800 BOB WILSON DR, SAN DIEGO, CA 92134-1098
(619) 532-6400
Mailing address
34800 BOB WILSON DR, SAN DIEGO, CA 92134-1098
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
8772825
UT
Other
Enumeration date
03/17/2014
Last updated
03/17/2014
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