Provider Demographics
NPI:1669550646
Name:AUSTRIA-SAGANA, CHONA MARTINEZ (DMD , INC)
Entity type:Individual
Prefix:DR
First Name:CHONA
Middle Name:MARTINEZ
Last Name:AUSTRIA-SAGANA
Suffix:
Gender:F
Credentials:DMD , INC
Other - Prefix:DR
Other - First Name:CHONA
Other - Middle Name:AUSTRIA
Other - Last Name:SAGANA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DMD
Mailing Address - Street 1:2720 E PLAZA BLVD
Mailing Address - Street 2:SUITE V
Mailing Address - City:NATIONAL CITY
Mailing Address - State:CA
Mailing Address - Zip Code:91950-4004
Mailing Address - Country:US
Mailing Address - Phone:619-267-2378
Mailing Address - Fax:619-475-5052
Practice Address - Street 1:2720 E PLAZA BLVD
Practice Address - Street 2:SUITE V
Practice Address - City:NATIONAL CITY
Practice Address - State:CA
Practice Address - Zip Code:91950-4004
Practice Address - Country:US
Practice Address - Phone:619-267-2378
Practice Address - Fax:619-475-5052
Is Sole Proprietor?:No
Enumeration Date:2006-11-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA370781223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice