Rodney D Ida Dds Apc | |
17542 Irvine Blvd Ste A Tustin CA 92780-3155 | |
(714) 547-8494 | |
(714) 547-3448 |
Full Name | Rodney D Ida Dds Apc |
---|---|
Speciality | Dentist - Endodontics |
Location | 17542 Irvine Blvd Ste A, Tustin, California |
Authorized Official Name and Position | Rodney Dean Ida (PRESIDENT) |
Authorized Official Contact | 7145478494 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Rodney D Ida Dds Apc 17542 Irvine Blvd Suite A Tustin CA 92780-3155 Ph: (714) 547-8494 | Rodney D Ida Dds Apc 17542 Irvine Blvd Ste A Tustin CA 92780-3155 Ph: (714) 547-8494 |
NPI Number | 1922210665 |
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Provider Enumeration Date | 05/04/2007 |
Last Update Date | 11/08/2017 |
Identifier | Type | State | Issuer |
---|---|---|---|
1922210665 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
122300000X | Dentist | 36250 (California) | Secondary |
1223E0200X | Dentist - Endodontics | CA36250 (California) | Primary |
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