Individual
ANDREA FORTES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
1076 E 1ST ST, SUITE E, TUSTIN, CA 92780-3852
(714) 838-5454
(714) 838-0532
Mailing address
1076 E 1ST ST, SUITE E, TUSTIN, CA 92780-3852
(714) 838-5454
(714) 838-0532
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
53450
CA
Other
Enumeration date
03/17/2014
Last updated
03/17/2014
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