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Organization

CARLOS FERNANDO DENTAL CORPORATION

Active
Other names
AMAZING SMILE DENTAL
Organization subpart
No

Provider details

NPI number
Authorized official
MS. LUPE A GOME (ADMINISTRATOR)
(714) 856-7135
Entity
Organization

Contact information

Practice address
999 N TUSTIN AVE STE 9&10, SANTA ANA, CA 92705-3528
(714) 856-7135
(714) 960-3309
Mailing address
9151 ATLANTA AVE UNIT 7891, HUNTINGTON BEACH, CA 92615-2613
(714) 856-7135
(714) 960-3309

Taxonomy

Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary

Other

Enumeration date
01/14/2019
Last updated
01/14/2019
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