Organization
PEMA PROFESSIONAL DENTAL CORP
Active
Other names
fountain valley dental esthetics
Organization subpart
No
Provider details
NPI number
Authorized official
DR. NILESH PEMA D.D.S (OWNER)
(714) 887-4337
Entity
Organization
Contact information
Practice address
17900 BROOKHURST ST, SUITE A, FOUNTAIN VALLEY, CA 92708-5141
(714) 887-4337
(714) 887-4339
Mailing address
17900 BROOKHURST ST, SUITE A, FOUNTAIN VALLEY, CA 92708-5141
(714) 887-4337
(714) 887-4339
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
48536
CA
Other
Enumeration date
02/12/2010
Last updated
02/12/2010
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