| Tustin Blue Dental Group | |
|
13362 Newport Ave Ste D Tustin CA 92780-3427 | |
| (714) 669-7705 | |
| (714) 669-7705 |
| Full Name | Tustin Blue Dental Group |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 13362 Newport Ave, Tustin, California |
| Authorized Official Name and Position | Williams D Saraiva (PRESIDENT) |
| Authorized Official Contact | 7146697705 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Tustin Blue Dental Group 13362 Newport Ave Ste D Tustin CA 92780-3427 Ph: (714) 669-7705 | Tustin Blue Dental Group 13362 Newport Ave Ste D Tustin CA 92780-3427 Ph: (714) 669-7705 |
| NPI Number | 1568748234 |
|---|---|
| Provider Enumeration Date | 10/26/2011 |
| Last Update Date | 03/14/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1568748234 | NPI | - | NPPES |
| 49405 | Other | CA | DENTAL BOARD OF CALIFORNIA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | (* (Not Available)) | Primary |
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