Organization
MARISA PODESTO DDS, DENTAL CORPORATION
Active
Other names
Bonita Dental Center
Organization subpart
No
Provider details
NPI number
Authorized official
TODD LUDDEN DDS (ASSOCIATE)
(619) 267-2115
Entity
Organization
Contact information
Practice address
5050 BONITA RD, BONITA, CA 91902-1701
(619) 267-2115
(619) 354-4166
Mailing address
5050 BONITA RD, BONITA, CA 91902-1701
(619) 267-2115
(619) 354-4166
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
61894
CA
Other
Enumeration date
01/03/2018
Last updated
11/12/2019
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