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Organization
DIMPLE MANCHANDIA DDS, INC
Active
Organization
DIMPLE MANCHANDIA DDS, INC
Active
Other names
Dentistry Blossom
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DIMPLE MANCHANDIA DDS (OWNER DENTIST)
(714) 832-7220
Entity
Organization
Contact information
Practice address
18102 IRVINE BLVD, SUITE 200, TUSTIN, CA 92780-3402
(714) 832-7220
(714) 832-7233
Mailing address
18102 IRVINE BLVD, SUITE 200, TUSTIN, CA 92780-3402
(714) 832-7220
(714) 832-7233
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
46882
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1013085208
NPI #
CA
Enumeration date
10/27/2010
Last updated
10/27/2010
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