Individual
DR. JEREMY IAN FACTOR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
6080 LAKE MURRAY BLVD, SUITE A, LA MESA, CA 91942-2572
(619) 466-6666
(619) 466-2639
Mailing address
6080 LAKE MURRAY BLVD, SUITE A, LA MESA, CA 91942-2572
(619) 466-6666
(619) 466-2639
Taxonomy
Speciality
Code
Description
License number
State
1223P0300X
Periodontics
Primary
54139
CA
Other
Enumeration date
12/21/2006
Last updated
11/05/2009
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