| Dr Oscar A Bracamontes | |
|
1144 13th St Suite 102 Imperial Beach CA 91932-3675 | |
| (619) 946-1071 | |
| Not Available |
| Full Name | Dr Oscar A Bracamontes |
|---|---|
| Speciality | Dentist |
| Location | 1144 13th St, Imperial Beach, California |
| Authorized Official Name and Position | Oscar A Bracamontes (OWNER) |
| Authorized Official Contact | 6199461071 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Oscar A Bracamontes Po Box 999 Imperial Beach CA 91933-0999 Ph: (619) 778-6765 | Dr Oscar A Bracamontes 1144 13th St Suite 102 Imperial Beach CA 91932-3675 Ph: (619) 946-1071 |
| NPI Number | 1174078745 |
|---|---|
| Provider Enumeration Date | 08/23/2016 |
| Last Update Date | 08/23/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1174078745 | NPI | - | NPPES |
| 2763785 | Other | CA | LICENSE NUMBER |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 2763785 (California) | Primary |
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