Provider Demographics
NPI:1225754252
Name:DR GOLPA-DENTAL IMPLANT SPECIALISTS OF CALIFORNIA PC
Entity Type:Organization
Organization Name:DR GOLPA-DENTAL IMPLANT SPECIALISTS OF CALIFORNIA PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:MIGUEL
Authorized Official - Middle Name:
Authorized Official - Last Name:ESTRELLA
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:619-383-1400
Mailing Address - Street 1:3500 MAPLE AVE STE 1600
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75219-3936
Mailing Address - Country:US
Mailing Address - Phone:330-949-9095
Mailing Address - Fax:
Practice Address - Street 1:2452 FENTON ST
Practice Address - Street 2:
Practice Address - City:CHULA VISTA
Practice Address - State:CA
Practice Address - Zip Code:91914-3599
Practice Address - Country:US
Practice Address - Phone:619-768-0111
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-10-12
Last Update Date:2022-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental