Individual
BEATRIZ VIDALES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
744 GRAND AVE STE 203, SAN MARCOS, CA 92078-1241
(760) 744-0004
(760) 744-0001
Mailing address
744 GRAND AVE STE 203, SAN MARCOS, CA 92078-1241
(760) 744-0004
(760) 744-0001
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
45212
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
980769
UNITED CONCORDIA
CA
01
—
B4521201
MEDI-CAL IDENTIFICATION #
CA
Enumeration date
02/14/2006
Last updated
09/18/2025
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