Organization
ALLEGIANCE DENTAL INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
STUART T TANI DDS (OWNER)
(858) 279-6100
Entity
Organization
Contact information
Practice address
4690 GENESEE AVE, SUITE B, SAN DIEGO, CA 92117-3000
(858) 279-6100
(858) 279-6112
Mailing address
4690 GENESEE AVE, SUITE B, SAN DIEGO, CA 92117-3000
(858) 279-6100
(858) 279-6112
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
32622
CA
Other
Enumeration date
08/09/2011
Last updated
06/29/2012
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