Provider Demographics
NPI:1700504164
Name:LAYTON DENTAL CORP
Entity Type:Organization
Organization Name:LAYTON DENTAL CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER, DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:RONALD
Authorized Official - Middle Name:D
Authorized Official - Last Name:LAYTON III
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:602-690-8257
Mailing Address - Street 1:3750 CONVOY ST STE 307
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92111-3741
Mailing Address - Country:US
Mailing Address - Phone:858-277-4453
Mailing Address - Fax:
Practice Address - Street 1:3750 CONVOY ST STE 307
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92111-3741
Practice Address - Country:US
Practice Address - Phone:858-277-4453
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-08-19
Last Update Date:2022-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty