Organization
BOTROS & NGUYEN DENTAL CORP
Active
Other names
Crystal Smile Dental
Organization subpart
No
Provider details
NPI number
Authorized official
SAMER F BOTROS (GENERAL MANAGER)
(714) 754-1888
Entity
Organization
Contact information
Practice address
2502 S BRISTOL ST, SANTA ANA, CA 92704
(714) 754-1888
(714) 754-0888
Mailing address
2502 S BRISTOL ST, SANTA ANA, CA 92704
(714) 754-1888
(714) 754-0888
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
45093
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
G9398201
—
CA
Enumeration date
12/14/2006
Last updated
08/22/2020
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