Organization
COMMUNITY DENTAL GROUP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. STEVEN DESTLER DDS (DENTIST/OWNER)
(805) 499-1253
Entity
Organization
Contact information
Practice address
587 N VENTU PARK RD STE C, NEWBURY PARK, CA 91320-2743
(805) 499-1253
(805) 499-1453
Mailing address
587 N VENTU PARK RD STE C, NEWBURY PARK, CA 91320-2743
(805) 499-1253
(805) 499-1453
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
41396
CA
Other
Enumeration date
01/12/2015
Last updated
01/12/2015
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