Organization
DEAN AZZEH , DDS INC.
Active
Other names
Family Orthodontics & Oral Surgery
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DEAN AZZEH DDS, INC (PRESIDENT/OWNER)
(714) 544-0200
Entity
Organization
Contact information
Practice address
535 E MAIN ST STE A, TUSTIN, CA 92780-4453
(714) 544-0200
(714) 509-1517
Mailing address
535 E MAIN ST STE A, TUSTIN, CA 92780-4453
(714) 544-0200
(714) 509-1517
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1669670931
—
CA
Enumeration date
12/04/2020
Last updated
02/17/2021
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