| Oral Prime | |
|
15708 Pomerado Rd Ste N101 Poway CA 92064-2066 | |
| (858) 524-1257 | |
| (858) 524-1259 |
| Full Name | Oral Prime |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 15708 Pomerado Rd Ste N101, Poway, California |
| Authorized Official Name and Position | Norva Gamboa (PRESIDENT) |
| Authorized Official Contact | 8585241257 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Oral Prime 15708 Pomerado Rd Ste N101 Poway CA 92064-2066 Ph: (858) 524-1257 | Oral Prime 15708 Pomerado Rd Ste N101 Poway CA 92064-2066 Ph: (858) 524-1257 |
| NPI Number | 1548916398 |
|---|---|
| Provider Enumeration Date | 03/01/2022 |
| Last Update Date | 06/08/2022 |
| Certification Date | 06/08/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1548916398 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | (NU) | Primary |
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