| Schuppet Dental Corporation | |
|
12791 Newport Ave Ste 208 Tustin CA 92780-8023 | |
| (714) 544-1740 | |
| Not Available |
| Full Name | Schuppet Dental Corporation |
|---|---|
| Speciality | Dentist - Orthodontics And Dentofacial Orthopedics |
| Location | 12791 Newport Ave Ste 208, Tustin, California |
| Authorized Official Name and Position | Henry C Schuppert (PRESIDENT) |
| Authorized Official Contact | 9498639620 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Schuppet Dental Corporation 20062 Sw Birch St Ste 220 Newport Beach CA 92660-1519 Ph: (949) 863-9620 | Schuppet Dental Corporation 12791 Newport Ave Ste 208 Tustin CA 92780-8023 Ph: (714) 544-1740 |
| NPI Number | 1104141316 |
|---|---|
| Provider Enumeration Date | 03/30/2010 |
| Last Update Date | 03/30/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1104141316 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223X0400X | Dentist - Orthodontics And Dentofacial Orthopedics | 54324 (California) | Primary |
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