Organization
IVONNE VAZQUEZ DDS INC
Active
Other names
Overland Dental Practice
Organization subpart
No
Provider details
NPI number
Authorized official
DR. IVONNE VAZQUEZ DDS (DENTIST)
(951) 695-8711
Entity
Organization
Contact information
Practice address
41653 MARGARITA RD STE 107, TEMECULA, CA 92591-3000
(951) 695-8711
Mailing address
41653 MARGARITA RD STE 107, TEMECULA, CA 92591-3000
(951) 695-8711
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
50392
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
161-908-6733
NPI INDIVIDUAL
CA
Enumeration date
09/17/2015
Last updated
09/17/2015
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