# SIGNATURE ENDODONTICS

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1699899211
- **Authorized official:** DR. WYATT DONALD SIMONS D.D.S. (DENTIST)
- **Authorized official phone:** (949) 498-2115

## Contact information

- **Practice address:** 2710 CAMINO CAPISTRANO, SAN CLEMENTE, CA 92672-4802
- **Practice address phone:** (949) 498-2115
- **Practice address fax:** (949) 498-2473
- **Mailing address:** 2710 CAMINO CAPISTRANO, SAN CLEMENTE, CA 92672-4802
- **Mailing address phone:** (949) 498-2115
- **Mailing address fax:** (949) 498-2473

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223E0200X | Endodontics | — | — | Yes |

## Other

- **Enumeration date:** 03/19/2007
- **Last updated:** 06/25/2008