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Organization

INTERNATIONAL DENTAL PROVIDERS CORP.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. ANGEL SERRANO DDS (OWNER)
(619) 691-8180
Entity
Organization

Contact information

Practice address
1594 WOODLARK CT, CHULA VISTA, CA 91911-5321
(619) 691-8180
(619) 691-1201
Mailing address
1594 WOODLARK CT, CHULA VISTA, CA 91911-5321
(619) 691-8180
(619) 691-1201

Taxonomy

Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
512443
ZZ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
104
DENTAL HEALTH SERVICES OF CALIFORNIA
CA
01
1141
SAFEGUARD HEALTH PLANS, INC.
CA
01
1185
GOLDEN WEST HEALTH PLANS, INC
CA
01
1327
CALIFORNIA DENTAL NETWORK, INC
CA
01
1369
WESTERN DENTAL SERVICES, INC
CA
01
325977
PACIFIC UNION DENTAL, INC
CA
01
351398
UNITED CONCORDIA DENTAL PLANS OF CALIFORNIA, INC
CA
01
4048
LIBERTY DENTAL PLANS OF CALIFORNIA
CA
01
44010
PACIFICARE DENTAL & VISION ADMINISTRATORS
CA
Enumeration date
08/11/2008
Last updated
08/11/2008
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