Organization
COURTNEY L. STAADECKER, DDS, MS AND SCOTT T. OZAKI, DDS, INC.
Active
Other names
Eastlake Periodontics and Implants
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SCOTT TADASHI OZAKI D.D.S. (OWNER)
(619) 482-3205
Entity
Organization
Contact information
Practice address
2452 FENTON ST, SUITE 302, CHULA VISTA, CA 91914-3516
(619) 482-3205
(619) 482-3206
Mailing address
2452 FENTON ST, SUITE 302, CHULA VISTA, CA 91914-3516
(619) 482-3205
(619) 482-3206
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
41977
CA
Other
Enumeration date
09/06/2007
Last updated
09/06/2007
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