Individual
ALEXANDER JOSEPH VIDUNAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
NAVAL HOSPITAL CAMP PENDLETON, MERCY CIRCLE, CAMP PENDLETON, CA 92055-5191
(570) 490-2400
Mailing address
NAVAL HOSPITAL CAMP PENDLETON, BOX 555191 MERCY CIRCLE, CAMP PENDLETON, CA 92055-5191
(760) 719-4747
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DS042748
PA
390200000X
Student in an Organized Health Care Education/Training Program
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—
Other
Enumeration date
02/21/2020
Last updated
11/18/2020
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