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Organization

CHILDREN'S HOSPITAL OF ORANGE COUNTY

Active
Parent organization
CHILDREN'S HOSPITAL OF ORANGE COUNTY
Other names
CS Orthodontics
Organization subpart
Yes

Provider details

NPI number
Legal business name
CHILDREN'S HOSPITAL OF ORANGE COUNTY
Authorized official
MARK KELLY (DIRECTOR, PROF REVENUE CYCLE)
(714) 509-7861
Entity
Organization

Contact information

Practice address
1201 W LA VETA AVE, ORANGE, CA 92868-4203
(888) 770-2462
(855) 246-2329
Mailing address
1201 W LA VETA AVE, ORANGE, CA 92868-4203

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
1223G0001X
General Practice Dentistry
1223P0221X
Pediatric Dentistry
Primary
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
126800000X
Dental Assistant

Other

Enumeration date
03/13/2020
Last updated
03/13/2020
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