| M Mallempalli Professional Dental Corporation | |
|
600 Palm Ave Ste 116 Imperial Beach CA 91932-1245 | |
| (619) 628-8123 | |
| Not Available |
| Full Name | M Mallempalli Professional Dental Corporation |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 600 Palm Ave Ste 116, Imperial Beach, California |
| Authorized Official Name and Position | Manimanjari Mallempalli (PRESIDENT) |
| Authorized Official Contact | 6196288123 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| M Mallempalli Professional Dental Corporation 11412 Fairwind Ct San Diego CA 92130-8641 Ph: (760) 586-7056 | M Mallempalli Professional Dental Corporation 600 Palm Ave Ste 116 Imperial Beach CA 91932-1245 Ph: (619) 628-8123 |
| NPI Number | 1679070791 |
|---|---|
| Provider Enumeration Date | 04/06/2018 |
| Last Update Date | 04/06/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1679070791 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | 49586 (California) | Primary |
Oscar A Bracamontes Dds Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 1144 13th St, Suite 102, Imperial Beach, CA 91932 Phone: 619-946-1071 | |
Arnel Mariano, Dds.,inc. Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 743 Emory St, Imperial Beach, CA 91932 Phone: 619-424-8707 | |
M Mallempalli Professional Dental Corporation Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 600 Palm Ave., Suite#116, Imperial Beach, CA 91932 Phone: 619-628-8123 | |
Mary Ann V Sanvictores Dds Inc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 600 Palm Avenue, Suite 116, Imperial Beach, CA 91932 Phone: 619-628-8123 Fax: 619-628-8081 |