Provider Demographics
NPI:1194855767
Name:DENTAL ADMINISTRATVE SERVICES
Entity Type:Organization
Organization Name:DENTAL ADMINISTRATVE SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ERNESTO
Authorized Official - Middle Name:FERNANDO
Authorized Official - Last Name:OCHOA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:619-205-4604
Mailing Address - Street 1:4492 CAMINO DE LA PLZ
Mailing Address - Street 2:#1166
Mailing Address - City:SAN YSIDRO
Mailing Address - State:CA
Mailing Address - Zip Code:92173-3003
Mailing Address - Country:US
Mailing Address - Phone:619-205-4604
Mailing Address - Fax:
Practice Address - Street 1:4492 CAMINO DE LA PLZ
Practice Address - Street 2:#1166
Practice Address - City:SAN YSIDRO
Practice Address - State:CA
Practice Address - Zip Code:92173-3003
Practice Address - Country:US
Practice Address - Phone:619-205-4604
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-06
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management