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27462 Calle Arroyo Ste 46b San Juan Capistrano CA 92675-6762 | |
| (562) 240-3054 | |
| (562) 317-5260 |
| Full Name | |
|---|---|
| Speciality | Dentist - Oral And Maxillofacial Surgery |
| Location | 27462 Calle Arroyo Ste 46b, San Juan Capistrano, California |
| Authorized Official Name and Position | Dorothea Berry (OMFS) |
| Authorized Official Contact | 5622403054 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
2690 Pacific Ave Ste 250 Long Beach CA 90806-2663 Ph: (562) 240-3054 | 27462 Calle Arroyo Ste 46b San Juan Capistrano CA 92675-6762 Ph: (562) 240-3054 |
| NPI Number | 1659861425 |
|---|---|
| Provider Enumeration Date | 05/16/2018 |
| Last Update Date | 05/16/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1659861425 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223S0112X | Dentist - Oral And Maxillofacial Surgery | 52968 (California) | Primary |
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