Organization
RICHARD L. BOTZBACH II DENTAL CORPORATION
Active
Other names
Nellie Gail Orthodontics
Organization subpart
No
Provider details
NPI number
Authorized official
RICHARD LLOYD BOTZBACH II D.D.S., M.S. (OWNER, PRESIDENT)
(949) 362-9971
Entity
Organization
Contact information
Practice address
6 B LIBERTY, SUITE 220, ALISO VIEJO, CA 92656-5835
(949) 362-9971
(949) 362-9886
Mailing address
6 B LIBERTY, SUITE 220, ALISO VIEJO, CA 92656-5835
(949) 362-9971
(949) 362-9886
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
39235
CA
Other
Enumeration date
03/10/2010
Last updated
03/10/2010
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