NPI 1750575403

Pacific Dental Clinic

Organisation Preferred Provider Organization Anaheim, CA

Practice location

Address: 1201 N Euclid St, Anaheim, CA 92801-1954
Phone: (714) 817-8345
Fax: (714) 224-7688

Authorised official

Name: Jorge Luis Geronimo
Title: Dentist
Phone: (714) 817-8345

Registered specialties

Preferred Provider Organization Primary

Managed Care Organizations Taxonomy 305R00000X Licence 47897 (CA)

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Registry record

NPI: 1750575403
Entity type: Organization
NPI issued: 5 Sep 2007
Record last updated: 5 Sep 2007

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.