| Childrens Primary Dental Care & Adult Dental Group | |
|
397 E St Ste #a Chula Vista CA 91910 | |
| (619) 425-9930 | |
| (619) 425-9887 |
| Full Name | Childrens Primary Dental Care & Adult Dental Group |
|---|---|
| Speciality | Dentist - Pediatric Dentistry |
| Location | 397 E St, Chula Vista, California |
| Authorized Official Name and Position | Safoura Massoumi (OWNER) |
| Authorized Official Contact | 6194259930 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Childrens Primary Dental Care & Adult Dental Group 397 E St Ste #a Chula Vista CA 91910 Ph: (619) 425-9930 | Childrens Primary Dental Care & Adult Dental Group 397 E St Ste #a Chula Vista CA 91910 Ph: (619) 425-9930 |
| NPI Number | 1306988118 |
|---|---|
| Provider Enumeration Date | 02/12/2007 |
| Last Update Date | 05/15/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1306988118 | NPI | - | NPPES |
| G9226501 | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0221X | Dentist - Pediatric Dentistry | 40677 (California) | Primary |
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