Provider Demographics
NPI:1386096899
Name:ORANGE DENTAL CARE
Entity type:Organization
Organization Name:ORANGE DENTAL CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:INS COORD
Authorized Official - Prefix:
Authorized Official - First Name:PATTY
Authorized Official - Middle Name:
Authorized Official - Last Name:BARTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:714-282-2490
Mailing Address - Street 1:1122 E LINCOLN AVE STE 104
Mailing Address - Street 2:
Mailing Address - City:ORANGE
Mailing Address - State:CA
Mailing Address - Zip Code:92865-1908
Mailing Address - Country:US
Mailing Address - Phone:714-282-2490
Mailing Address - Fax:
Practice Address - Street 1:1122 E LINCOLN AVE STE 104
Practice Address - Street 2:
Practice Address - City:ORANGE
Practice Address - State:CA
Practice Address - Zip Code:92865-1908
Practice Address - Country:US
Practice Address - Phone:714-282-2490
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-07-08
Last Update Date:2016-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA486301223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty