Jorge Vizcarra
Dentist, General Practice in Tijuana, BAJA CALIFORNIA. Organization (NPI-2).
NPI number1902307697
StatusActive
Last updated in NPPESFeb 27, 2018
Details
- NPI
- 1902307697
- Entity type
- Organization (NPI-2)
- Legal business name
- Jorge Vizcarra
- Organization subpart
- No
- Enumeration date
- Feb 27, 2018
- Last updated
- Feb 27, 2018
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 1223G0001X | Dentist, General Practice | 4125102 | – | Yes |
Other names
- Jorge Vizcarra (Former Legal Business Name)
Practice location
Ruta Hidalgo #9720Tijuana, BAJA CALIFORNIA 22223
Mexico
Phone 619-488-3200 · Fax 866-272-6924
Mailing address
Ruta Hidalgo #9720Tijuana, BAJA CALIFORNIA 22223
Mexico
Authorized official
Jorge Vizcarra
Dentist
6194883200
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