Organization
BURGETT DENTAL CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RAY BAHAE (PARTNER)
(858) 361-3322
Entity
Organization
Contact information
Practice address
4541 COLLEGE AVE, SAN DIEGO, CA 92115-4010
(619) 582-6000
(619) 582-6002
Mailing address
4541 COLLEGE AVE, SAN DIEGO, CA 92115-4010
(619) 582-6000
(619) 582-6002
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
—
124Q00000X
Dental Hygienist
—
—
126800000X
Dental Assistant
—
—
Other
Enumeration date
03/18/2015
Last updated
03/18/2015
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