Organization
VISTA FAMILY DENTAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
VALERIE A ROGERS (OFFICE ASSISTANT)
(951) 677-5113
Entity
Organization
Contact information
Practice address
630 ALTA VISTA DR STE 108, VISTA, CA 92084-5505
(760) 405-8389
Mailing address
630 ALTA VISTA DR STE 108, VISTA, CA 92084-5505
(760) 724-6537
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
53656
CA
Other
Enumeration date
09/11/2017
Last updated
09/11/2017
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