Organization
BALDEN GALLO MICHELS PROF DENTAL CORP
Active
Other names
South Bay Chula Vista Family Dental
Organization subpart
No
Provider details
NPI number
Authorized official
NICOLE REID (REGIONAL MANAGER)
(619) 261-1670
Entity
Organization
Contact information
Practice address
290 LANDIS AVE, SUITE A & B, CHULA VISTA, CA 91910-2636
(619) 691-0121
(619) 691-0841
Mailing address
290 LANDIS AVE, SUITE A & B, CHULA VISTA, CA 91910-2636
(619) 691-0121
(619) 691-0841
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
31040
CA
Other
Enumeration date
08/25/2006
Last updated
08/22/2020
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