Provider Demographics
NPI:1316042930
Name:ROMANOWSKY & BREZINER LA JOLLA FAMILY SMILE DESIGN DENTAL GROUP
Entity Type:Organization
Organization Name:ROMANOWSKY & BREZINER LA JOLLA FAMILY SMILE DESIGN DENTAL GROUP
Other - Org Name:LA JOLLA FAMILY SMILE DESIGN
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:JAIME
Authorized Official - Middle Name:J
Authorized Official - Last Name:BREZINER
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:858-454-3043
Mailing Address - Street 1:7817 IVANHOE AVE
Mailing Address - Street 2:SUITE 305
Mailing Address - City:LA JOLLA
Mailing Address - State:CA
Mailing Address - Zip Code:92037
Mailing Address - Country:US
Mailing Address - Phone:858-454-3043
Mailing Address - Fax:858-454-6410
Practice Address - Street 1:7817 IVANHOE AVE
Practice Address - Street 2:SUITE 305
Practice Address - City:LA JOLLA
Practice Address - State:CA
Practice Address - Zip Code:92037
Practice Address - Country:US
Practice Address - Phone:858-454-3043
Practice Address - Fax:858-454-6410
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-14
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty