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NPI Code Detail

MEDICARE: DENTAL SLEEP THERAPY, A PROFESSIONAL DENTAL GROUP BY F BURRELL DDS

MEDICARE: DENTAL SLEEP THERAPY, A PROFESSIONAL DENTAL GROUP BY F BURRELL DDS
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11223G0001XGeneral Practice DentistryD27767CA
21223G0001XGeneral Practice DentistryD24950CA

General Provider Information

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

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