|
| |
|
777 Corporate Dr Suite 100 Ladera Ranch CA 92694-2135 | |
| (949) 429-0049 | |
| (425) 671-0756 |
| Full Name | |
|---|---|
| Speciality | Dentist |
| Location | 777 Corporate Dr, Ladera Ranch, California |
| Authorized Official Name and Position | Shanalee Ackerman (MANAGER) |
| Authorized Official Contact | 4255031607 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
777 Corporate Dr Suite 100 Ladera Ranch CA 92694-2135 Ph: (949) 429-0049 | 777 Corporate Dr Suite 100 Ladera Ranch CA 92694-2135 Ph: (949) 429-0049 |
| NPI Number | 1740619980 |
|---|---|
| Provider Enumeration Date | 11/08/2013 |
| Last Update Date | 11/08/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1740619980 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 61389 (California) | Primary |
Vigliarolo, D.d.s. Dental Corp Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 600 Corporate Dr #220, Ladera Ranch, CA 92694 Phone: 949-429-3944 | |
Azita S. Ebrahimi Dds Inc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 25662 Crown Valley Pkwy Ste H4, Ladera Ranch, CA 92694 Phone: 949-276-2990 | |
Parker And Hales Dental Partnership Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 777 Corporate Dr Ste 100, Ladera Ranch, CA 92694 Phone: 949-429-0049 Fax: 949-606-9274 | |
Christine Chung Dental Corp Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 27702 Crown Valley Pkwy Ste A2, Ladera Ranch, CA 92694 Phone: 949-365-1900 Fax: 949-365-1909 |