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Organization
MICHAEL Q NGO
Active
Organization
MICHAEL Q NGO
Active
Other names
Family Dentistry
Organization subpart
No
Provider details
NPI number
Authorized official
EVELINE K GANI (OFFICE MANAGER)
(714) 680-3377
Entity
Organization
Contact information
Practice address
1332 E CHAPMAN AVE, FULLERTON, CA 92831-3954
(714) 680-3377
(714) 680-0098
Mailing address
1332 E CHAPMAN AVE, FULLERTON, CA 92831-3954
(714) 680-3377
(714) 680-0098
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
42376
CA
Other
Enumeration date
12/19/2007
Last updated
08/04/2008
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