Provider Demographics
NPI:1104586593
Name:SELINA SARNO, DDS, INC
Entity type:Organization
Organization Name:SELINA SARNO, DDS, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:SELINA ANN
Authorized Official - Middle Name:S
Authorized Official - Last Name:SARNO
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:562-704-8783
Mailing Address - Street 1:26700 TOWNE CENTRE DR STE 200
Mailing Address - Street 2:
Mailing Address - City:FOOTHILL RANCH
Mailing Address - State:CA
Mailing Address - Zip Code:92610-2845
Mailing Address - Country:US
Mailing Address - Phone:949-830-3511
Mailing Address - Fax:949-830-0997
Practice Address - Street 1:26700 TOWNE CENTRE DR STE 200
Practice Address - Street 2:
Practice Address - City:FOOTHILL RANCH
Practice Address - State:CA
Practice Address - Zip Code:92610-2845
Practice Address - Country:US
Practice Address - Phone:949-830-3511
Practice Address - Fax:949-830-0997
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-12-27
Last Update Date:2021-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental