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30131 Town Center Dr Ste 196 Laguna Niguel CA 92677-2040 | |
(949) 363-3350 | |
Not Available |
Full Name | |
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Speciality | Dentist - Orthodontics And Dentofacial Orthopedics |
Location | 30131 Town Center Dr Ste 196, Laguna Niguel, California |
Authorized Official Name and Position | Travis Kinser (OWNER DOCTOR) |
Authorized Official Contact | 9493633350 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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30131 Town Center Dr Ste 196 Laguna Niguel CA 92677-2040 Ph: (949) 363-3350 | 30131 Town Center Dr Ste 196 Laguna Niguel CA 92677-2040 Ph: (949) 363-3350 |
NPI Number | 1104699487 |
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Provider Enumeration Date | 10/30/2023 |
Last Update Date | 12/07/2023 |
Identifier | Type | State | Issuer |
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1104699487 | NPI | - | NPPES |
1851926596 | Medicaid | CA |
Taxonomy | Type | License (State) | Status |
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1223X0400X | Dentist - Orthodontics And Dentofacial Orthopedics | (* (Not Available)) | Primary |
Balaze & Gregg Dentistry Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 30131 Town Center Dr Ste 250, Laguna Niguel, CA 92677 Phone: 949-770-7686 | |
Glenn P. Frial, Dds, Ms, A Professional Corporation Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 28202 Cabot Rd, Suite 250, Laguna Niguel, CA 92677 Phone: 949-276-2105 Fax: 949-276-2109 |