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Organization
OC DENTAL SPECIALISTS
Active
Organization
OC DENTAL SPECIALISTS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
THOMAS MICHAEL BOONE (DENTIST)
(714) 898-5600
Entity
Organization
Contact information
Practice address
11702 BEACH BLVD, STANTON, CA 90680-3609
(714) 898-5600
Mailing address
PO BOX 1543, SUNSET BEACH, CA 90742-1543
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
34661
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1285932954
—
CA
Enumeration date
07/12/2017
Last updated
07/12/2017
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