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Organization
MARK A. GEORGE D.D.S., INC
Active
Organization
MARK A. GEORGE D.D.S., INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. DIANA LESLIE COSTELLO (OFFICE ADMINISTRATOR)
(714) 953-1000
Entity
Organization
Contact information
Practice address
1140 W LA VETA AVE STE 530, ORANGE, CA 92868-4227
(714) 953-1000
(714) 953-9957
Mailing address
1140 W LA VETA AVE STE 530, ORANGE, CA 92868-4227
(714) 953-1000
(714) 953-9957
Taxonomy
Speciality
Code
Description
License number
State
1223P0700X
Prosthodontics
Primary
31142
CA
Other
Enumeration date
09/01/2010
Last updated
09/01/2010
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