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General NPI Number Information
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NPI Number | 1083202766
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Entity Type | Organization
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Legal Business Name | DUONG DENTAL, INC.
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Dates
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Enumeration Date | 01/07/2021
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Last Update Date | 06/09/2021
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Provider Practice Location Address
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Address Line | 24000 ALICIA PKWY STE 18
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City | MISSION VIEJO
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State | CA
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Zip | 92691-3929
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Country | US
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Telephone | 949-427-2239
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Fax |
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Provider Business Mailing Address
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Address Line | 24000 ALICIA PKWY STE 18
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City | MISSION VIEJO
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State | CA
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Zip | 92691-3929
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Country | US
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Telephone | 949-427-2239
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Fax |
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Authorized Official
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Title or Position | COO
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Name | IULIAN GEORGESCU
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Credential |
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Telephone | 949-427-1122
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number |
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License Number State |
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