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General NPI Number Information
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NPI Number | 1104149038
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Entity Type | Organization
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Legal Business Name | MARIA V SANTOS, DMD, INC
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Dates
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Enumeration Date | 03/06/2010
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Last Update Date | 03/06/2010
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Provider Practice Location Address
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Address Line | 24910 LAS BRISAS RD SUITE 104
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City | MURRIETA
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State | CA
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Zip | 92562-4010
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Country | US
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Telephone | 951-445-4407
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Fax | 951-445-4421
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Provider Business Mailing Address
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Address Line | 1103 W ORANGETHORPE AVE
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City | FULLERTON
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State | CA
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Zip | 92833-4735
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Country | US
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Telephone | 714-871-8093
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Fax | 714-871-8133
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Authorized Official
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Title or Position | DENTIST
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Name | DR. MARIA VENERACION SANTOS
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Credential | DMD
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Telephone | 951-445-4407
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 39078
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License Number State | CA
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