Individual
SURISADAI AQUIT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
910 E OHIO AVE, ESCONDIDO, CA 92025-3438
(833) 867-4642
Mailing address
2063 HARRISON AVE, SAN DIEGO, CA 92113-1227
(617) 447-5702
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
111379
CA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/06/2023
Last updated
04/28/2025
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