Organization
COSTA MESA CORP.
Active
Other names
SoCal Smiles Dentistry
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RINESH GANATRA D.D.S. (OWNER)
(949) 766-0006
Entity
Organization
Contact information
Practice address
230 E 17TH ST, SUITE 208, COSTA MESA, CA 92627-3824
(949) 645-0045
(949) 645-0055
Mailing address
230 E 17TH ST, SUITE 208, COSTA MESA, CA 92627-3824
(949) 645-0045
(949) 645-0055
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
5007
CA
Other
Enumeration date
09/12/2008
Last updated
09/12/2008
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