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31876 Del Obispo St Ste 103 San Juan Capistrano CA 92675-3240 | |
| (949) 538-4250 | |
| (949) 535-1391 |
| Full Name | |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 31876 Del Obispo St Ste 103, San Juan Capistrano, California |
| Authorized Official Name and Position | Shorouq Sameer Sahawneh (OWNER DENTIST) |
| Authorized Official Contact | 7145786358 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
675 Anton Blvd Ste 500 Costa Mesa CA 92626-1919 Ph: (949) 308-9792 | 31876 Del Obispo St Ste 103 San Juan Capistrano CA 92675-3240 Ph: (949) 538-4250 |
| NPI Number | 1497585004 |
|---|---|
| Provider Enumeration Date | 08/07/2024 |
| Last Update Date | 08/07/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1497585004 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
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