Organization
CLINICA DENTAL INTEGRAL
Active
Parent organization
AMEXUS DENTAL PPO
Organization subpart
Yes
Provider details
NPI number
Legal business name
AMEXUS DENTAL PPO
Authorized official
JESSICA SERRANO (ADMINISTRATOR)
(619) 270-2243
Entity
Organization
Contact information
Practice address
3045 S ARCHIBALD AVE, SUITE H-289, ONTARIO, CA 91761-9001
(909) 758-8275
Mailing address
9379 IGNACIO COMONFORT, SUITE 'B', TIJUANA, BAJA CALIFORNIA 22210
(619) 270-2243
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
MX15793
ZZ
Other
Enumeration date
10/16/2008
Last updated
10/16/2008
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