Organization
SOUTH BAY ENDODONTICS
Active
Parent organization
LA JOLLA DENTAL SPECIALTY GROUP
Organization subpart
Yes
Provider details
NPI number
Legal business name
LA JOLLA DENTAL SPECIALTY GROUP
Authorized official
DR. DUKE HUYNH NGUYEN D.D.S (OWNER)
(619) 421-3374
Entity
Organization
Contact information
Practice address
885 CANARIOS CT, SUITE 208, CHULA VISTA, CA 91910-7877
(619) 421-3374
(619) 421-3410
Mailing address
885 CANARIOS CT, SUITE 208, CHULA VISTA, CA 91910-7877
(619) 421-3374
(619) 421-3410
Taxonomy
Speciality
Code
Description
License number
State
1223E0200X
Endodontics
Primary
47399
CA
Other
Enumeration date
04/20/2009
Last updated
04/20/2009
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