Provider Demographics
NPI:1962790212
Name:JESCH, NORMAN H JR (DDS)
Entity type:Individual
Prefix:DR
First Name:NORMAN
Middle Name:H
Last Name:JESCH
Suffix:JR
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Mailing Address - Street 1:12665 GARDEN GROVE BLVD
Mailing Address - Street 2:STE. 107
Mailing Address - City:GARDEN GROVE
Mailing Address - State:CA
Mailing Address - Zip Code:92843-1901
Mailing Address - Country:US
Mailing Address - Phone:714-638-1050
Mailing Address - Fax:714-530-8614
Practice Address - Street 1:12665 GARDEN GROVE BLVD
Practice Address - Street 2:STE. 107
Practice Address - City:GARDEN GROVE
Practice Address - State:CA
Practice Address - Zip Code:92843-1901
Practice Address - Country:US
Practice Address - Phone:714-638-1050
Practice Address - Fax:714-530-8614
Is Sole Proprietor?:Yes
Enumeration Date:2011-07-20
Last Update Date:2011-07-20
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CA233261223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice