Organization
HNC ORTHODONTIC GROUP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SHANNON NISSEN (OWNER)
(949) 830-4101
Entity
Organization
Contact information
Practice address
26302 LA PAZ RD STE 202, MISSION VIEJO, CA 92691-5328
(949) 830-4101
Mailing address
26302 LA PAZ RD STE 202, MISSION VIEJO, CA 92691-5328
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
56349
CA
Other
Enumeration date
01/10/2011
Last updated
01/10/2011
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