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Individual

ANNA CHAVEZ

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
D.D.S

Contact information

Practice address
125 N TUSTIN ST, ORANGE, CA 92867-7755
(714) 988-6615
Mailing address
125 N TUSTIN ST, ORANGE, CA 92867-7755

Taxonomy

Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
DDS107375
CA
390200000X
Student in an Organized Health Care Education/Training Program

Other

Enumeration date
04/07/2019
Last updated
03/21/2023
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