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DR. JONATHAN DAVID ALBAUGH D.M.D., M.B.A
Orthodontics and Dentofacial Orthopedics >> Dentist >> Dental ProvidersRegistrant NPI Number: 1225262371
Individual Registrant:DR. JONATHAN DAVID ALBAUGH D.M.D., M.B.A
Gender: M
Sole Proprietor
Gender: M
Sole Proprietor
Location and contact information for practice:
40760 CALIFORNIA OAKS RD MURRIETA, CA 92562-5791 US
Tel: 951-677-3079 Fax: --
Tel: 951-677-3079 Fax: --
Contact information for business:
30 MAIN ST STE G-140 VISTA, CA 92083-5860 US
Tel: 760-527-2846 Fax: 760-842-0430
Tel: 760-527-2846 Fax: 760-842-0430
Registration Information:
NPI: 1225262371
Entity Type: Individual
Entity Type: Individual
Specialty information:
| Primary | Code | Category/Description | State | License Number |
|---|---|---|---|---|
| N | 1223X0400X | Dental Providers Dentist Orthodontics and Dentofacial Orthopedics | NV | 6142 |
| Y | 1223X0400X | Dental Providers Dentist | CA | 63587 |
| N | 122300000X | Dental Providers Dentist | MA | 22262 |
Legacy codes, insurance codes and state license numbers:
| Issuer | Number | State | Type |
|---|---|---|---|
