Provider Demographics
NPI:1407944374
Name:SO CAL DENTAL PARTNERS
Entity Type:Organization
Organization Name:SO CAL DENTAL PARTNERS
Other - Org Name:SC DENTAL CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:HEATHER
Authorized Official - Middle Name:ANGEL
Authorized Official - Last Name:FOSTER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:949-770-3010
Mailing Address - Street 1:22972 MOULTON PKWY
Mailing Address - Street 2:#106
Mailing Address - City:LAGUNA HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:92653
Mailing Address - Country:US
Mailing Address - Phone:949-770-3010
Mailing Address - Fax:949-837-5410
Practice Address - Street 1:22972 MOULTON PKWY
Practice Address - Street 2:#106
Practice Address - City:LAGUNA HILLS
Practice Address - State:CA
Practice Address - Zip Code:92653
Practice Address - Country:US
Practice Address - Phone:949-770-3010
Practice Address - Fax:949-837-5410
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-10
Last Update Date:2008-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty