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1922705029
EMILIIA MGDVELADZE
SANTA MARIA, CA
NPI
1922705029
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
1223G0001X Dentist, General Practice
(Licence: CA 108568)
Enumeration Date
2023-02-09
Last Update Date
2023-05-06
Business Address
Dr. EMILIIA MGDVELADZE DDS
2205 S BROADWAY OFC 122
SANTA MARIA, CA 93454-7813
Phone number: 805-863-9430
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Mailing Address
Dr. EMILIIA MGDVELADZE DDS
680 LONGBRANCH AVE
GROVER BEACH, CA 93433-2306
Phone number: 424-216-0718
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