# ROBERT T CADALSO JR PROFESSIONAL DENTAL CORPORATION

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Genesis Dental Group
- **Organization subpart:** No

## Provider details

- **NPI number:** 1265853881
- **Authorized official:** DR. ROBERT TOMAS CADALSO JR. D. D.S. (PRESIDENT)
- **Authorized official phone:** (949) 770-5266

## Contact information

- **Practice address:** 24896 CHRISANTA DR, STE 110, MISSION VIEJO, CA 92691-4800
- **Practice address phone:** (949) 770-5266
- **Practice address fax:** (949) 770-7534
- **Mailing address:** 24896 CHRISANTA DR, SUITE 110, MISSION VIEJO, CA 92691-4800
- **Mailing address phone:** (949) 770-5266
- **Mailing address fax:** (949) 770-7534

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QD0000X | Dental Clinic/Center | 30639 | CA | Yes |

## Other

- **Enumeration date:** 12/27/2013
- **Last updated:** 08/22/2014