Capitol Dental Care | |
1202 Bristol St. Ste. #110 Costa Mesa CA 92626 | |
(714) 979-8008 | |
Not Available |
Full Name | Capitol Dental Care |
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Speciality | Dentist - General Practice |
Location | 1202 Bristol St., Costa Mesa, California |
Authorized Official Name and Position | Theresa M Nguyenduc (PRESIDENT) |
Authorized Official Contact | 7149798008 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Capitol Dental Care 1202 Bristol St. Ste. #110 Costa Mesa CA 92626 Ph: (714) 979-8008 | Capitol Dental Care 1202 Bristol St. Ste. #110 Costa Mesa CA 92626 Ph: (714) 979-8008 |
NPI Number | 1710174586 |
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Provider Enumeration Date | 09/26/2007 |
Last Update Date | 09/26/2007 |
Identifier | Type | State | Issuer |
---|---|---|---|
1710174586 | NPI | - | NPPES |
B39853-01 | Other | CA | DENTI-CAL |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
1223G0001X | Dentist - General Practice | 39853 (California) | Primary |
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