Individual
BRANDON KIAN GINO MAROON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
310 3RD AVE STE C1B, CHULA VISTA, CA 91910-3954
(619) 476-1600
Mailing address
PO BOX 3104, RANCHO SANTA FE, CA 92067-3104
(858) 386-6363
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
107362
CA
Other
Enumeration date
03/15/2022
Last updated
03/15/2022
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