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Organization
PEMA PROFESSIONAL DENTAL CORP
Active
Organization
PEMA PROFESSIONAL DENTAL CORP
Active
Other names
fountain valley dental esthetics
Organization subpart
No
Provider details
NPI number
Authorized official
DR. NILESH PEMA D.D.S (OWNER)
(714) 887-4337
Entity
Organization
Contact information
Practice address
17900 BROOKHURST ST, SUITE A, FOUNTAIN VALLEY, CA 92708-5141
(714) 887-4337
(714) 887-4339
Mailing address
17900 BROOKHURST ST, SUITE A, FOUNTAIN VALLEY, CA 92708-5141
(714) 887-4337
(714) 887-4339
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
48536
CA
Other
Enumeration date
02/12/2010
Last updated
02/12/2010
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