| Katchooi Dental Group Inc | |
|
12630 Monte Vista Rd Ste 108 Poway CA 92064-2526 | |
| (858) 312-5242 | |
| Not Available |
| Full Name | Katchooi Dental Group Inc |
|---|---|
| Speciality | Dentist - Orthodontics And Dentofacial Orthopedics |
| Location | 12630 Monte Vista Rd Ste 108, Poway, California |
| Authorized Official Name and Position | Mina Katchooi (OWNER) |
| Authorized Official Contact | 4783901960 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Katchooi Dental Group Inc 7814 Inception Way San Diego CA 92108-5122 Ph: (478) 390-1960 | Katchooi Dental Group Inc 12630 Monte Vista Rd Ste 108 Poway CA 92064-2526 Ph: (858) 312-5242 |
| NPI Number | 1295465367 |
|---|---|
| Provider Enumeration Date | 06/13/2022 |
| Last Update Date | 06/13/2022 |
| Certification Date | 06/13/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1295465367 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223X0400X | Dentist - Orthodontics And Dentofacial Orthopedics | () | Primary |
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