Organization
SAN DIEGO DENTAL ANESTHESIA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TYLER JOHNSON DDS (PRESIDENT)
(619) 339-0760
Entity
Organization
Contact information
Practice address
1287 CARLSBAD VILLAGE DRIVE, CARLSBAD, CA 92008
(619) 339-0760
Mailing address
8677 VILLA LA JOLLA DR # 1255, LA JOLLA, CA 92037-2354
(619) 339-0760
Taxonomy
Speciality
Code
Description
License number
State
1223D0004X
Dental Anesthesiology
Primary
—
—
Other
Enumeration date
06/25/2019
Last updated
06/25/2019
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