| Socal Orthodontics | |
|
613 N Azusa Ave Ste A Azusa CA 91702-2968 | |
| (626) 633-0066 | |
| Not Available |
| Full Name | Socal Orthodontics |
|---|---|
| Speciality | Dentist - Orthodontics And Dentofacial Orthopedics |
| Location | 613 N Azusa Ave Ste A, Azusa, California |
| Authorized Official Name and Position | Garrett Dacker (PRESIDENT) |
| Authorized Official Contact | 6264840075 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Socal Orthodontics 1365 Pebble Springs Ln Glendora CA 91741-2353 | Socal Orthodontics 613 N Azusa Ave Ste A Azusa CA 91702-2968 Ph: (626) 633-0066 |
| NPI Number | 1649738980 |
|---|---|
| Provider Enumeration Date | 03/06/2019 |
| Last Update Date | 03/06/2019 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1649738980 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223X0400X | Dentist - Orthodontics And Dentofacial Orthopedics | () | Primary |
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