Jefferson Dental
NPI #1154638500 in La Quinta, California
Provider Information
- NPI Number
- 1154638500
- Entity Type
- Organization
- Organization Name
- Jefferson Dental
- Primary Specialty
- Dentist - General Practice
- Enumeration Date
- Sep 7, 2010
- Last Updated
- Sep 7, 2010
Practice Location
- Address
- 79800 HIGHWAY 111 STE 109
- City
- La Quinta
- State
- California
- ZIP Code
- 92253-6003
- Phone
- (760) 775-0600
Authorized Official
- Name
- DR. SYEDA SHABNAM HUQ, DDS
- Title
- OWNER
- Phone
- (760) 775-0600
Specialties & Taxonomy Codes
| Specialty |
|---|
| Dentist - General Practice — General Practice |
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