Individual
ALONSO BREACH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2906 W SOUTH MOUNTAIN RD, LAVEEN, AZ 85339-7804
(619) 831-0437
(619) 785-3404
Mailing address
3554 SUNSET LN UNIT 32, SAN YSIDRO, CA 92173-4506
(619) 831-0437
(619) 785-3404
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
10929112
ZZ
Other
Enumeration date
06/03/2025
Last updated
06/03/2025
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