Organization
NORTH TUSTIN DENTAL SPECIALTY CENTER INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. SHERLENE TING (ADMINISTRATOR)
(626) 375-0656
Entity
Organization
Contact information
Practice address
18102 IRVINE BLVD STE 211, TUSTIN, CA 92780-3414
(714) 838-2001
Mailing address
1245 W HUNTINGTON DR STE 103, ARCADIA, CA 91007-6384
(626) 898-9787
Taxonomy
Speciality
Code
Description
License number
State
1223E0200X
Endodontics
Primary
—
—
1223P0106X
Oral and Maxillofacial Pathology Dentistry
—
—
1223P0300X
Periodontics
—
—
Other
Enumeration date
05/31/2024
Last updated
05/31/2024
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