Provider Demographics
NPI:1285353862
Name:DAMERJI NATIONAL DENTAL CORPORATION
Entity type:Organization
Organization Name:DAMERJI NATIONAL DENTAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:GEORGE
Authorized Official - Middle Name:
Authorized Official - Last Name:DAMERJI
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:773-562-1826
Mailing Address - Street 1:2355 SAWGRASS ST
Mailing Address - Street 2:
Mailing Address - City:EL CAJON
Mailing Address - State:CA
Mailing Address - Zip Code:92019-4560
Mailing Address - Country:US
Mailing Address - Phone:773-562-1826
Mailing Address - Fax:
Practice Address - Street 1:941 BROADWAY STE B
Practice Address - Street 2:
Practice Address - City:EL CAJON
Practice Address - State:CA
Practice Address - Zip Code:92021-4707
Practice Address - Country:US
Practice Address - Phone:773-562-1826
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-08-25
Last Update Date:2022-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental