Provider Demographics
NPI:1982625539
Name:BIANCHI AND JOUGLARD DENTAL CORPORATION
Entity Type:Organization
Organization Name:BIANCHI AND JOUGLARD DENTAL CORPORATION
Other - Org Name:DOVE CANYON DENTAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/SECRETARY
Authorized Official - Prefix:DR
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:EUGENE
Authorized Official - Last Name:BIANCHI
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:949-589-4100
Mailing Address - Street 1:30212 TOMAS
Mailing Address - Street 2:SUITE 300
Mailing Address - City:RANCHO SANTA MARGARITA
Mailing Address - State:CA
Mailing Address - Zip Code:92688
Mailing Address - Country:US
Mailing Address - Phone:949-589-4100
Mailing Address - Fax:949-589-8015
Practice Address - Street 1:30212 TOMAS
Practice Address - Street 2:SUITE 300
Practice Address - City:RANCHO SANTA MARGARITA
Practice Address - State:CA
Practice Address - Zip Code:92688
Practice Address - Country:US
Practice Address - Phone:949-589-4100
Practice Address - Fax:949-589-8015
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-21
Last Update Date:2022-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA473511223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty