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Organization

NIEVA SOCORRO R. BAUTISTA D.M.D., INC

Active
Other names
Vista Foothill Dentistry
Organization subpart
No

Provider details

NPI number
Authorized official
NIEVA R. BAUTISTA (CEO/OWNER)
(760) 724-7645
Entity
Organization

Contact information

Practice address
1293 E VISTA WAY, VISTA, CA 92084-4039
(760) 724-7645
(760) 724-7640
Mailing address
1293 E VISTA WAY, VISTA, CA 92084-4039
(760) 724-7645
(760) 724-7640

Taxonomy

Speciality
Code
Description
License number
State
305R00000X
Preferred Provider Organization
Primary
47229
CA

Other

Enumeration date
05/17/2007
Last updated
06/03/2014
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