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31920 Del Obispo St Ste 160 San Juan Capistrano CA 92675-3193 | |
| (562) 695-5251 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 31920 Del Obispo St Ste 160, San Juan Capistrano, California |
| Authorized Official Name and Position | Shalini Shah (OWNER DENTIST) |
| Authorized Official Contact | 7143797755 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
31920 Del Obispo St Ste 160 San Juan Capistrano CA 92675-3193 Ph: () - | 31920 Del Obispo St Ste 160 San Juan Capistrano CA 92675-3193 Ph: (562) 695-5251 |
| NPI Number | 1376365379 |
|---|---|
| Provider Enumeration Date | 10/30/2024 |
| Last Update Date | 01/10/2025 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1376365379 | NPI | - | NPPES |
| 51304 | Other | CA | DENTAL LICENSE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
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