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MS. DEBORAH D. LANDIS RDH

>> Dental Hygienist >> Dental Providers

Registrant NPI Number: 1821162116

Individual Registrant:
MS. DEBORAH D. LANDIS RDH
Gender: F
Sole Proprietor

Location and contact information for practice:
MCRD DENTAL CLINIC 43000 MIDWAY AVE.  SAN DEIGO, CA 92140-5592 US
Tel: 619-524-4009  Fax: --

Contact information for business:
11485 MATINAL CIR  SAN DIEGO, CA 92127-1235 US
Tel: 858-485-8404  Fax: --

Registration Information:
NPI: 1821162116
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y124Q00000XDental Providers
Dental Hygienist
CARDH15370

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType




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