| Castaneda Fassioli Dental Corp | |
|
22706 Aspan St Ste 602 Lake Forest CA 92630-1603 | |
| (949) 716-7000 | |
| (949) 716-0600 |
| Full Name | Castaneda Fassioli Dental Corp |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 22706 Aspan St Ste 602, Lake Forest, California |
| Authorized Official Name and Position | Carolyn Elizabeth Castaneda Fassioli (CEO) |
| Authorized Official Contact | 9497167000 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Castaneda Fassioli Dental Corp 22706 Aspan St Ste 602 Lake Forest CA 92630-1603 Ph: (949) 716-7000 | Castaneda Fassioli Dental Corp 22706 Aspan St Ste 602 Lake Forest CA 92630-1603 Ph: (949) 716-7000 |
| NPI Number | 1598270993 |
|---|---|
| Provider Enumeration Date | 12/07/2017 |
| Last Update Date | 02/11/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1598270993 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | 101094 (California) | Primary |
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