Individual
MS. DEBORAH D. LANDIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RDH
Contact information
Practice address
MCRD DENTAL CLINIC 43000 MIDWAY AVE., SAN DEIGO, CA 92140-5592
(619) 524-4009
Mailing address
11485 MATINAL CIR, SAN DIEGO, CA 92127-1235
(858) 485-8404
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
RDH15370
CA
Other
Enumeration date
11/20/2006
Last updated
07/08/2007
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