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3358 S Bristol St Santa Ana CA 92705 | |
| (714) 361-2141 | |
| (714) 979-1659 |
| Full Name | |
|---|---|
| Speciality | Dentist |
| Location | 3358 S Bristol St, Santa Ana, California |
| Authorized Official Name and Position | Shorouq Sahawneh (PRESIDENT) |
| Authorized Official Contact | 7145786358 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
3358 S Bristol St Santa Ana CA 92705 Ph: (714) 361-2141 | 3358 S Bristol St Santa Ana CA 92705 Ph: (714) 361-2141 |
| NPI Number | 1063773661 |
|---|---|
| Provider Enumeration Date | 05/31/2012 |
| Last Update Date | 07/24/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1063773661 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 55643 (California) | Primary |
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Secondary |
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