Organization
MOBILE DENTAL CLEANING
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARY ANN MCCONNELL (OWNER)
(949) 697-7373
Entity
Organization
Contact information
Practice address
14 PASEO LUNA, SAN CLEMENTE, CA 92673-6501
(949) 697-7303
Mailing address
14 PASEO LUNA, SAN CLEMENTE, CA 92673-6501
(949) 697-7303
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
HAP 229
CA
Other
Enumeration date
10/08/2014
Last updated
10/08/2014
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