| Fountain Modern Dentistry And Orthodontics | |
|
2860 Michelle Drive 2nd Floor Irvine CA 92606 | |
| (714) 368-2077 | |
| (714) 368-2092 |
| Full Name | Fountain Modern Dentistry And Orthodontics |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 2860 Michelle Drive 2nd Floor, Irvine, California |
| Authorized Official Name and Position | Charles Rodgers (DDS/ OWNER) |
| Authorized Official Contact | 7193824936 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Fountain Modern Dentistry And Orthodontics 6940 Mesa Ridge Parkway Fountain CO 80817 Ph: (719) 382-4936 | Fountain Modern Dentistry And Orthodontics 2860 Michelle Drive 2nd Floor Irvine CA 92606 Ph: (714) 368-2077 |
| NPI Number | 1730434622 |
|---|---|
| Provider Enumeration Date | 07/17/2012 |
| Last Update Date | 07/17/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1730434622 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 9356 (Colorado) | Primary |
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