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Organization
LEE WATANABE AND NOSTI DENTAL CORPORATION
Active
Organization
LEE WATANABE AND NOSTI DENTAL CORPORATION
Active
Other names
Hemet Dental Group and Orthodontics
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BRYAN K WATANABE DDS (OWNER DDS)
(951) 658-9980
Entity
Organization
Contact information
Practice address
4000 W FLORIDA AVE, HEMET, CA 92545-5279
(951) 658-9980
(951) 929-0541
Mailing address
2860 MICHELLE DRIVE, 2ND FLOOR, IRVINE, CA 92606-1009
(714) 508-3600
(714) 368-2092
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
40130
CA
1223P0300X
Periodontics
37772
CA
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
53124
CA
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
49975
CA
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
51049
CA
Other
Enumeration date
09/22/2006
Last updated
06/04/2012
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