Ida Alfonso Dmd INC

NPI #1104279579 in Carlsbad, California

Provider Information

NPI Number: 1104279579
Entity Type: Organization
Organization Name: Ida Alfonso Dmd INC
Primary Specialty: Dentist
Enumeration Date: Jul 20, 2016
Last Updated: Jul 20, 2016

Practice Location

Address: 5814 VAN ALLEN WAY
City: Carlsbad
State: California
ZIP Code: 92008-7358
Phone: (760) 931-0144

Authorized Official

Name: IDA ALFONSO
Title: OWNER
Phone: (760) 931-0144

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist	122300000X	Primary

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