Organization
NBDC SAN DIEGO
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PETER A RUOCCO (DIRECTOR FOR DENTAL SERVICES)
(619) 556-8200
Entity
Organization
Contact information
Practice address
2310 CRAVEN ST, SAN DIEGO, CA 92136-5596
(619) 556-8200
Mailing address
2310 CRAVEN ST, SAN DIEGO, CA 92136-5596
(619) 556-8200
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
02/01/2008
Last updated
02/01/2008
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