Organization
BRAVO DENTAL CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LUZ S BRAVO DDS (PRESIDENT/DENTIST)
(714) 635-0892
Entity
Organization
Contact information
Practice address
215 N STATE COLLEGE BLVD STE E, ANAHEIM, CA 92806-2934
(714) 635-0892
Mailing address
215 N STATE COLLEGE BLVD STE E, ANAHEIM, CA 92806-2934
(714) 635-0892
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
09/02/2024
Last updated
09/02/2024
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