| L R Eversole A Dental Corporation | |
|
9292 Chesapeake Dr Ste 100 San Diego CA 92123-1059 | |
| (858) 492-9500 | |
| Not Available |
| Full Name | L R Eversole A Dental Corporation |
|---|---|
| Speciality | Dentist - Oral And Maxillofacial Pathology |
| Location | 9292 Chesapeake Dr Ste 100, San Diego, California |
| Authorized Official Name and Position | Lewis R Eversole (PRESIDENT) |
| Authorized Official Contact | 8584929500 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| L R Eversole A Dental Corporation Po Box 643 Poway CA 92074-0643 Ph: (858) 513-3889 | L R Eversole A Dental Corporation 9292 Chesapeake Dr Ste 100 San Diego CA 92123-1059 Ph: (858) 492-9500 |
| NPI Number | 1861452641 |
|---|---|
| Provider Enumeration Date | 03/24/2006 |
| Last Update Date | 03/22/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1861452641 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0106X | Dentist - Oral And Maxillofacial Pathology | (* (Not Available)) | Primary |
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