| Smiles On Bristol Dentistry | |
|
2502 S Bristol St Santa Ana CA 92704-5725 | |
| (714) 662-2000 | |
| Not Available |
| Full Name | Smiles On Bristol Dentistry |
|---|---|
| Speciality | Dentist |
| Location | 2502 S Bristol St, Santa Ana, California |
| Authorized Official Name and Position | Danial Rezaei Kalantari (CEO) |
| Authorized Official Contact | 7146622000 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Smiles On Bristol Dentistry 2502 S Bristol St Santa Ana CA 92704-5725 Ph: (714) 662-2000 | Smiles On Bristol Dentistry 2502 S Bristol St Santa Ana CA 92704-5725 Ph: (714) 662-2000 |
| NPI Number | 1548653249 |
|---|---|
| Provider Enumeration Date | 03/05/2015 |
| Last Update Date | 03/05/2015 |
| Medicare PECOS PAC ID | 0345676482 |
|---|---|
| Medicare Enrollment ID | O20200207001304 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1548653249 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 61075 (California) | Primary |
| Provider Name | Danial Rezaei Kalantari |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1649549130 PECOS PAC ID: 1254767395 Enrollment ID: I20200207001353 |
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