West Cobb Dentist Office, PC

NPI #1144761727 in Irvine, California

Provider Information

NPI Number: 1144761727
Entity Type: Organization
Organization Name: West Cobb Dentist Office, PC
Primary Specialty: Dentist
Enumeration Date: Mar 15, 2017
Last Updated: Mar 15, 2017

Practice Location

Address: 17000 RED HILL AVE
City: Irvine
State: California
ZIP Code: 92614-5626
Phone: (678) 203-3464

Authorized Official

Name: JONATHAN BRIDWELL
Title: CREDENTIALING ADMIN
Phone: (714) 845-8231

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist	122300000X	Primary

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