Provider Demographics
NPI:1861527681
Name:NEWMAN SOTO DENTAL GROUP
Entity type:Organization
Organization Name:NEWMAN SOTO DENTAL GROUP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:FORTUNATA
Authorized Official - Middle Name:R
Authorized Official - Last Name:SOTO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:619-275-2626
Mailing Address - Street 1:3065 CLAIREMONT DR STE C
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92117-6974
Mailing Address - Country:US
Mailing Address - Phone:619-275-2626
Mailing Address - Fax:619-275-5937
Practice Address - Street 1:3065 CLAIREMONT DR STE C
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92117-6974
Practice Address - Country:US
Practice Address - Phone:619-275-2626
Practice Address - Fax:619-275-5937
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-22
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty
Not Answered1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Multi-Specialty