Organization
SMILENDODONTICS INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHELLE DANG (ENDODONTIST)
(626) 552-8207
Entity
Organization
Contact information
Practice address
9520 TALBERT AVE, FOUNTAIN VALLEY, CA 92708-5145
(714) 587-9041
Mailing address
9520 TALBERT AVE, FOUNTAIN VALLEY, CA 92708-5145
Taxonomy
Speciality
Code
Description
License number
State
1223E0200X
Endodontics
Primary
60157
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1205148921
ENDODONTIST
CA
Enumeration date
05/20/2017
Last updated
05/20/2017
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