Provider Demographics
NPI:1588850002
Name:MADSEN ANDRUS THOMPSON AND SOELBERG PARTNERSHIP
Entity Type:Organization
Organization Name:MADSEN ANDRUS THOMPSON AND SOELBERG PARTNERSHIP
Other - Org Name:NORTH COUNTY ORAL & FACIAL SURGERY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:ELIZABETH
Authorized Official - Middle Name:
Authorized Official - Last Name:GOMEZ
Authorized Official - Suffix:
Authorized Official - Credentials:MBA
Authorized Official - Phone:760-432-8888
Mailing Address - Street 1:839 E GRAND AVE
Mailing Address - Street 2:
Mailing Address - City:ESCONDIDO
Mailing Address - State:CA
Mailing Address - Zip Code:92025-3401
Mailing Address - Country:US
Mailing Address - Phone:760-432-8888
Mailing Address - Fax:760-432-0179
Practice Address - Street 1:839 E GRAND AVE
Practice Address - Street 2:
Practice Address - City:ESCONDIDO
Practice Address - State:CA
Practice Address - Zip Code:92025-3401
Practice Address - Country:US
Practice Address - Phone:760-432-8888
Practice Address - Fax:760-432-0179
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-18
Last Update Date:2023-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial SurgeryGroup - Single Specialty