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Individual

DR. ERIC DRIVER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DDS

Contact information

Practice address
4060 4TH AVE, SUITE #303, SAN DIEGO, CA 92103-2116
(619) 543-0905
Mailing address
4076 PENINSULA DR, CARLSBAD, CA 92010-5564
(816) 210-2196

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
59069
CA
1223G0001X
General Practice Dentistry
2004017842
MO
1223P0300X
Periodontics
Primary
59069
CA

Other

Enumeration date
09/23/2005
Last updated
01/28/2010
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