| NPI | 1730390477 |
|---|---|
| Doing Business As | COASTDENTAL |
| Entity Type | Organization |
| Authorized Contact | THOMAS WILLIAM MADDOCKS Dentist Owner 760-758-9400 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: CA 32352) |
| Enumeration Date | 2007-05-24 |
| Last Update Date | 2020-08-22 |