Provider Demographics
NPI:1760869796
Name:NESS DENTAL CORPORATION
Entity Type:Organization
Organization Name:NESS DENTAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DOUGLAS
Authorized Official - Middle Name:G
Authorized Official - Last Name:NESS
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:907-360-2690
Mailing Address - Street 1:2405 TRANSPORTATION AVE
Mailing Address - Street 2:
Mailing Address - City:NATIONAL CITY
Mailing Address - State:CA
Mailing Address - Zip Code:91950-6664
Mailing Address - Country:US
Mailing Address - Phone:619-474-6200
Mailing Address - Fax:619-477-4059
Practice Address - Street 1:2405 TRANSPORTATION AVE
Practice Address - Street 2:
Practice Address - City:NATIONAL CITY
Practice Address - State:CA
Practice Address - Zip Code:91950-6664
Practice Address - Country:US
Practice Address - Phone:619-474-6200
Practice Address - Fax:619-477-4059
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-04-28
Last Update Date:2015-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA37266122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Multi-Specialty