| Talega Coast Dentistry | |
|
1031 Avenida Pico Ste 203 San Clemente CA 92673-6356 | |
| (949) 361-6900 | |
| Not Available |
| Full Name | Talega Coast Dentistry |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 1031 Avenida Pico Ste 203, San Clemente, California |
| Authorized Official Name and Position | Dean Rollolazo (CEO/BUSINESS MANAGER) |
| Authorized Official Contact | 2063516252 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Talega Coast Dentistry 1031 Avenida Pico Ste 203 San Clemente CA 92673-6356 Ph: (949) 361-6900 | Talega Coast Dentistry 1031 Avenida Pico Ste 203 San Clemente CA 92673-6356 Ph: (949) 361-6900 |
| NPI Number | 1316343742 |
|---|---|
| Provider Enumeration Date | 11/12/2014 |
| Last Update Date | 11/12/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1316343742 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | 54070 (California) | Primary |
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