Organization
SHARE OUR SELVES CORPORATION
Active
Other names
SOS - Beauchamp Dental Center, SOS - Dr. Robert & Dorothy Beauchamp Children & Family Dental Center
Organization subpart
No
Provider details
NPI number
Authorized official
CHRISTY WARD (CEO)
(949) 536-3927
Entity
Organization
Contact information
Practice address
307 PLACENTIA AVE STE 202, NEWPORT BEACH, CA 92663-3308
(949) 270-2100
(949) 515-5804
Mailing address
PO BOX 10159, COSTA MESA, CA 92627-0050
(949) 270-2100
(949) 515-5804
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
—
—
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
Other
Enumeration date
09/04/2015
Last updated
07/29/2020
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