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General NPI Number Information
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NPI Number | 1477375160
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Entity Type | Organization
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Legal Business Name | MARIE ANTOINETTE OREJUDOS DMD INC.
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Dates
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Enumeration Date | 10/25/2024
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Last Update Date | 10/28/2024
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Provider Practice Location Address
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Address Line | 215 N STATE COLLEGE BLVD STE J
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City | ANAHEIM
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State | CA
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Zip | 92806-2995
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Country | US
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Telephone | 714-795-9804
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Fax |
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Provider Business Mailing Address
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Address Line | 610 S FANN PL
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City | ANAHEIM
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State | CA
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Zip | 92804-2623
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Country | US
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Telephone | 714-795-9804
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | MARIE ANTOINETTE DYQUIANGCO OREJUDOS
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Credential | DMD
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Telephone | 714-795-9804
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number |
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License Number State |
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