Provider Demographics
NPI:1366510562
Name:FRANCISCO, ANNIE MARIA (DMD)
Entity type:Individual
Prefix:
First Name:ANNIE
Middle Name:MARIA
Last Name:FRANCISCO
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:MARIA ANGELINA
Other - Middle Name:FRANCISCO
Other - Last Name:SUMBAD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DMD
Mailing Address - Street 1:1660 BROADWAY
Mailing Address - Street 2:STE 4
Mailing Address - City:CHULA VISTA
Mailing Address - State:CA
Mailing Address - Zip Code:91911-4895
Mailing Address - Country:US
Mailing Address - Phone:619-420-8279
Mailing Address - Fax:619-420-8287
Practice Address - Street 1:1660 BROADWAY
Practice Address - Street 2:SUITE #4
Practice Address - City:CHULA VISTA
Practice Address - State:CA
Practice Address - Zip Code:91911-4856
Practice Address - Country:US
Practice Address - Phone:619-420-8279
Practice Address - Fax:619-420-8287
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-04
Last Update Date:2018-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA467951223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice