# NORTH TUSTIN DENTAL SPECIALTY CENTER INC

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

## Provider details

- **NPI number:** 1700626116
- **Authorized official:** MS. SHERLENE TING (ADMINISTRATOR)
- **Authorized official phone:** (626) 375-0656

## Contact information

- **Practice address:** 18102 IRVINE BLVD STE 211, TUSTIN, CA 92780-3414
- **Practice address phone:** (714) 838-2001
- **Mailing address:** 1245 W HUNTINGTON DR STE 103, ARCADIA, CA 91007-6384
- **Mailing address phone:** (626) 898-9787

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223E0200X | Endodontics | — | — | Yes |
| 1223P0106X | Oral and Maxillofacial Pathology Dentistry | — | — | — |
| 1223P0300X | Periodontics | — | — | — |

## Other

- **Enumeration date:** 05/31/2024
- **Last updated:** 05/31/2024