| Genesis Dental Group | |
|
24896 Chrisanta Dr Ste 110 Mission Viejo CA 92691-4800 | |
| (949) 770-5266 | |
| (949) 770-7534 |
| Full Name | Genesis Dental Group |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 24896 Chrisanta Dr, Mission Viejo, California |
| Authorized Official Name and Position | Robert Tomas Cadalso (PRESIDENT) |
| Authorized Official Contact | 9497705266 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Genesis Dental Group 24896 Chrisanta Dr Suite 110 Mission Viejo CA 92691-4800 Ph: (949) 770-5266 | Genesis Dental Group 24896 Chrisanta Dr Ste 110 Mission Viejo CA 92691-4800 Ph: (949) 770-5266 |
| NPI Number | 1265853881 |
|---|---|
| Provider Enumeration Date | 12/27/2013 |
| Last Update Date | 08/22/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1265853881 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | 30639 (California) | Primary |
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