Provider Demographics
NPI:1437792488
Name:INTEGRITY ENDONTICS
Entity Type:Organization
Organization Name:INTEGRITY ENDONTICS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:BUONCRISTIANI
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:949-887-8915
Mailing Address - Street 1:5 RAEBURN LN
Mailing Address - Street 2:
Mailing Address - City:COTO DE CAZA
Mailing Address - State:CA
Mailing Address - Zip Code:92679-5126
Mailing Address - Country:US
Mailing Address - Phone:949-887-8915
Mailing Address - Fax:
Practice Address - Street 1:2121 E COAST HWY STE 100
Practice Address - Street 2:
Practice Address - City:CORONA DEL MAR
Practice Address - State:CA
Practice Address - Zip Code:92625-1912
Practice Address - Country:US
Practice Address - Phone:949-763-3004
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-10-22
Last Update Date:2019-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223E0200XDental ProvidersDentistEndodonticsGroup - Single Specialty