Organization
MOBILE DENTISTRY OF CA INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. VIJAY JAIN DMD (OWNER)
(949) 529-1095
Entity
Organization
Contact information
Practice address
13522 NEWPORT AVE, SUITE 102, TUSTIN, CA 92780-3707
(949) 529-1095
(949) 417-0292
Mailing address
4 BRAGG, IRVINE, CA 92620-3306
Taxonomy
Speciality
Code
Description
License number
State
332BC3200X
Customized Equipment (DME)
Primary
61024
CA
Other
Enumeration date
07/06/2016
Last updated
07/06/2016
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