Organization
ST. JUDE NEIGHBORHOOD HEALTH CENTERS
Active
Other names
St. Jude Dental Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
TIMOTHY JASON BROWN (CHIEF EXECUTIVE OFFICER)
(208) 899-9631
Entity
Organization
Contact information
Practice address
7758 KNOTT AVE, BUENA PARK, CA 90620-2420
(714) 522-8723
(714) 522-4182
Mailing address
731 S HIGHLAND AVE, FULLERTON, CA 92832-2753
(714) 522-8723
(714) 522-4182
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
05/09/2012
Last updated
06/17/2020
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