| Oral Maxillofacial Surgery Of Southern | |
|
105 Durian St Ste C Vista CA 92083-6240 | |
| (310) 601-8888 | |
| (714) 544-1008 |
| Full Name | Oral Maxillofacial Surgery Of Southern |
|---|---|
| Speciality | Dentist - Oral And Maxillofacial Surgery |
| Location | 105 Durian St, Vista, California |
| Authorized Official Name and Position | Ali Amrollahie (GENERAL PARTNER) |
| Authorized Official Contact | 9495107795 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Oral Maxillofacial Surgery Of Southern 105 Durian St Ste C Vista CA 92083-6240 Ph: (310) 601-8888 | Oral Maxillofacial Surgery Of Southern 105 Durian St Ste C Vista CA 92083-6240 Ph: (310) 601-8888 |
| NPI Number | 1184363731 |
|---|---|
| Provider Enumeration Date | 06/01/2022 |
| Last Update Date | 08/09/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1184363731 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | (* (Not Available)) | Secondary |
| 1223S0112X | Dentist - Oral And Maxillofacial Surgery | (* (Not Available)) | Primary |
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