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General NPI Number Information
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NPI Number | 1295207041
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Entity Type | Organization
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Legal Business Name | SHAWN P. PESH, DDS, MS, INC.
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Dates
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Enumeration Date | 12/18/2018
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Last Update Date | 12/18/2018
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Provider Practice Location Address
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Address Line | 41011 CALIFORNIA OAKS RD STE 201
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City | MURRIETA
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State | CA
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Zip | 92562-5751
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Country | US
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Telephone | 951-698-8200
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Fax |
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Provider Business Mailing Address
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Address Line | 41011 CALIFORNIA OAKS RD STE 201
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City | MURRIETA
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State | CA
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Zip | 92562-5751
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Country | US
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Telephone | 951-698-8200
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Fax |
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Authorized Official
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Title or Position | PRESIDENT/ORTHODONTIST
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Name | SHAWN P. PESH
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Credential | DDS, MS
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Telephone | 951-698-8200
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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