Provider Demographics
NPI:1982435541
Name:COLIN SUZMAN, BDS, DDS, A PROFESSIONAL CORP.
Entity type:Organization
Organization Name:COLIN SUZMAN, BDS, DDS, A PROFESSIONAL CORP.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:COLIN
Authorized Official - Middle Name:
Authorized Official - Last Name:SUZMAN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:949-552-6334
Mailing Address - Street 1:4330 BARRANCA PKWY STE 100
Mailing Address - Street 2:
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92604-4754
Mailing Address - Country:US
Mailing Address - Phone:949-552-6334
Mailing Address - Fax:949-417-1879
Practice Address - Street 1:4330 BARRANCA PKWY STE 100
Practice Address - Street 2:
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92604-4754
Practice Address - Country:US
Practice Address - Phone:949-552-6334
Practice Address - Fax:949-417-1879
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-08-13
Last Update Date:2024-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental