| Fabriel D Burquez | |
|
180 Otay Lakes Rd Ste 210b Bonita CA 91902-2400 | |
| (619) 479-4457 | |
| (619) 479-4827 |
| Full Name | Fabriel D Burquez |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 180 Otay Lakes Rd Ste 210b, Bonita, California |
| Authorized Official Name and Position | Fabriel Dario Burquez (DENTIST) |
| Authorized Official Contact | 6194794457 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Fabriel D Burquez 180 Otay Lakes Rd Ste 210b Bonita CA 91902-2400 Ph: (619) 479-4457 | Fabriel D Burquez 180 Otay Lakes Rd Ste 210b Bonita CA 91902-2400 Ph: (619) 479-4457 |
| NPI Number | 1982893087 |
|---|---|
| Provider Enumeration Date | 10/15/2007 |
| Last Update Date | 10/15/2007 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1982893087 | NPI | - | NPPES |
| G89774-01 | Other | CA | DENTICAL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | 49476 (California) | Primary |
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