| San Clemente Periodontics & Implants | |
|
1001 Avenida Pico Ste K San Clemente CA 92673-6956 | |
| (949) 361-4867 | |
| (949) 361-4868 |
| Full Name | San Clemente Periodontics & Implants |
|---|---|
| Speciality | Dentist - Periodontics |
| Location | 1001 Avenida Pico Ste K, San Clemente, California |
| Authorized Official Name and Position | Raymond L. Wright (PRESIDENT) |
| Authorized Official Contact | 9493614867 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| San Clemente Periodontics & Implants 1001 Avenida Pico Ste K San Clemente CA 92673-6956 Ph: (949) 361-4867 | San Clemente Periodontics & Implants 1001 Avenida Pico Ste K San Clemente CA 92673-6956 Ph: (949) 361-4867 |
| NPI Number | 1740868140 |
|---|---|
| Provider Enumeration Date | 03/30/2021 |
| Last Update Date | 09/20/2021 |
| Certification Date | 09/20/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1740868140 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0300X | Dentist - Periodontics | () | Primary |
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