Organization
MISSION PEDIATRIC DENTISTRY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PEDERSEN JOHN D.D.S. (OWNER)
(949) 364-1171
Entity
Organization
Contact information
Practice address
27800 MEDICAL CENTER RD STE 332, MISSION VIEJO, CA 92691-6409
(949) 364-1141
Mailing address
27800 MEDICAL CENTER RD STE 332, MISSION VIEJO, CA 92691-6409
(949) 364-1141
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
—
—
1223P0221X
Pediatric Dentistry
Primary
—
—
Other
Enumeration date
01/26/2007
Last updated
09/13/2007
Update your record
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