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Organization

MD DENTAL CORP

Active
Other names
Crown Valley Dental
Organization subpart
No

Provider details

NPI number
Authorized official
MICHAEL DIEP (PRESIDENT)
(714) 335-0514
Entity
Organization

Contact information

Practice address
27882 FORBES RD STE 204, LAGUNA NIGUEL, CA 92677-1267
(949) 249-2995
Mailing address
27882 FORBES RD STE 204, LAGUNA NIGUEL, CA 92677-1267
(949) 249-2995

Taxonomy

Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary

Other

Enumeration date
08/15/2023
Last updated
08/15/2023
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