OrganizationAllegiance Dental IncDentistDental ProvidersPractice Address4690 Genesee Ave, Suite B, San Diego, CA 92117-3000(858) 279-6100PECOS EnrollmentBased on the most recent information from CMS, provider Allegiance Dental Inc does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records yesterday at 12:57 PM.Profile DetailsProvider ID1740569631Provider TypeOrganizationFull NameAllegiance Dental IncSubpartNoEnumeration Date8/9/2011Last Updated6/29/2012Contact InformationPractice LocationPractice Address4690 Genesee Ave, Suite B, San Diego, CA 92117-3000Phone(858) 279-6100Fax(858) 279-6112Mailing LocationMailing Address4690 Genesee Ave, Suite B, San Diego, CA 92117-3000Phone(858) 279-6100Fax(858) 279-6112Authorized OfficialNameTani, Stuart T (Owner)Phone(858) 279-6100Provider TaxonomiesCodeDescriptionLicenseCode122300000XPrimaryDescriptionDentistDental ProvidersLicense32622California