Organization
BOYD DENTAL CORPORATION
Active
Other names
Alicia Orthodontic & Pediatric Specialties
Organization subpart
No
Provider details
NPI number
Authorized official
DEBBIE CANU (FINANCE MANAGER)
(949) 600-7046
Entity
Organization
Contact information
Practice address
24481 ALICIA PKWY, SUITE B-3, MISSION VIEJO, CA 92691-4534
(949) 586-9800
Mailing address
27 SPECTRUM POINTE DR, SUITE 308, LAKE FOREST, CA 92630-2273
(949) 600-7046
(949) 600-9899
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
48814
CA
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
44328
CA
Other
Enumeration date
01/12/2015
Last updated
01/12/2015
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