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Organization

AGNES S. MONDEJAR, D.D.S., INC.

Active
Other names
Brea Children's Dental
Organization subpart
No

Provider details

NPI number
Authorized official
AGNES S MONDEJAR D.D.S. (PRESIDENT)
(626) 536-6107
Entity
Organization

Contact information

Practice address
1245 W CENTRAL AVE, BREA, CA 92821-2407
(562) 691-3788
(562) 697-4686
Mailing address
1245 W CENTRAL AVE, BREA, CA 92821-2407
(562) 691-3788
(562) 697-4686

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
49603
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
G93555-01
DENTI-CAL
CA
Enumeration date
12/18/2014
Last updated
12/18/2014
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