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SANTIAGO ALFONSO SURILLO

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DDS MS

Contact information

Practice address
4700 SPRING STREET, SUITE 104, LA MESA, CA 91941
(619) 461-6166
(619) 461-2508
Mailing address
4700 SPRING STREET, SUITE 104, LA MESA, CA 91941
(619) 461-6166
(619) 461-2508

Taxonomy

Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
41045
CA
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
41045
CA

Other

Enumeration date
01/09/2007
Last updated
10/21/2014
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