Dr. Eric Driver, DDS
Dentist, Periodontics in San Diego, CA. Individual provider (NPI-1).
NPI number1497741672
StatusActive
Last updated in NPPESJan 28, 2010
Details
- NPI
- 1497741672
- Entity type
- Individual (NPI-1)
- Name
- Dr. Eric Driver
- Credential
- DDS
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Sep 23, 2005
- Last updated
- Jan 28, 2010
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 1223P0300X | Dentist, Periodontics | 59069 | CA | Yes |
| 1223G0001X | Dentist, General Practice | 2004017842 | MO | |
| 122300000X | Dentist | 59069 | CA |
Practice location
4060 4th AveSuite #303
San Diego, CA 92103-2116
Phone 619-543-0905
Mailing address
4076 Peninsula DrCarlsbad, CA 92010-5564
Phone 816-210-2196
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