| NPI | 1497048664 |
|---|---|
| Doing Business As | SUMMIT DENTAL OF LA MESA |
| Entity Type | Organization |
| Authorized Contact | RICHARD B. EVANS President 760-468-1828 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: CA 31914) |
| Additional Taxonomies | 1223X2210X Dentist, Orofacial Pain |
| 124Q00000X Dental Hygienist | |
| 1223G0001X Dentist, General Practice | |
| 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics | |
| Enumeration Date | 2011-05-22 |
| Last Update Date | 2024-02-06 |