NPI 1912196171

Grigory Rozenvich D.D.S., INC.

Organisation Exclusive Provider Organization Santa Ana, CA

Practice location

Address: 3620 S. Bristol St. Suite 210, Santa Ana, CA 92704
Phone: (714) 549-1409
Fax: (714) 549-2118

Authorised official

Name: Grigory Rozenovich
Title: President
Phone: (714) 549-1409

Registered specialties

Exclusive Provider Organization Primary

Managed Care Organizations Taxonomy 302F00000X Licence 40115 (CA)

Other Exclusive Provider Organization providers in California →

Registry record

NPI: 1912196171
Entity type: Organization
NPI issued: 23 Oct 2007
Record last updated: 6 May 2015

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.