Organization
PREMIER PEDIATRIC DENTISTRY INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DAGGIANA L CORGNELL (OFFICE MANAGER)
(949) 880-6683
Entity
Organization
Contact information
Practice address
24541 PACIFIC PARK DR STE 240, ALISO VIEJO, CA 92656-3050
(949) 880-6683
Mailing address
24541 PACIFIC PARK DR STE 240, ALISO VIEJO, CA 92656-3050
(949) 880-6683
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
—
—
Other
Enumeration date
11/05/2024
Last updated
11/05/2024
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