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General NPI Number Information
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NPI Number | 1235509597
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Entity Type | Organization
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Legal Business Name | DENTAL SLEEP THERAPY, A PROFESSIONAL DENTAL GROUP BY F BURRELL DDS
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Dates
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Enumeration Date | 09/30/2015
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Last Update Date | 01/27/2016
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Provider Practice Location Address
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Address Line | 30131 TOWN CENTER DRIVE SUITE 160
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City | LAGUNA NIGUEL
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State | CA
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Zip | 92677-2040
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Country | US
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Telephone | 949-342-0899
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Fax | 949-495-0642
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Provider Business Mailing Address
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Address Line | 30131 TOWN CENTER DRIVE SUITE 160
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City | LAGUNA NIGUEL
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State | CA
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Zip | 92677-2040
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Country | US
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Telephone | 949-342-0899
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Fax | 949-495-0642
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. FRANK J. BURRELL JR.
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Credential | DDS
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Telephone | 949-342-0899
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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 | D27767
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | D24950
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License Number State | CA
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