Provider First Line Business Practice Location Address:
9855 ERMA ROAD, #110
Provider Second Line Business Practice Location Address:
SCRIPPS PERIODONTICS
Provider Business Practice Location Address City Name:
SAN DIEGO
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
92131
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
240-383-7623
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
10/11/2017