| Tri-city Children's Dentistry | |
|
2420 Vista Way Ste 210 Oceanside CA 92054 | |
| (760) 724-1102 | |
| (760) 724-1471 |
| Full Name | Tri-city Children's Dentistry |
|---|---|
| Speciality | Dentist - Pediatric Dentistry |
| Location | 2420 Vista Way Ste 210, Oceanside, California |
| Authorized Official Name and Position | Jose Angelo Ragon Vasquez (PRESIDENT/PEDIATRIC DENTIST) |
| Authorized Official Contact | 7607241102 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Tri-city Children's Dentistry 2420 Vista Way Ste 210 Oceanside CA 92054-6190 Ph: (760) 724-1102 | Tri-city Children's Dentistry 2420 Vista Way Ste 210 Oceanside CA 92054 Ph: (760) 724-1102 |
| NPI Number | 1114297785 |
|---|---|
| Provider Enumeration Date | 01/12/2012 |
| Last Update Date | 12/21/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1114297785 | NPI | - | NPPES |
| D54036 | Medicaid | CA | |
| 1770613598 | Other | CA | NPI TYPE I |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0221X | Dentist - Pediatric Dentistry | 54036 (California) | Primary |
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