Costa Mesa Corp.

NPI #1508015603 in Costa Mesa, California

Provider Information

NPI Number: 1508015603
Entity Type: Organization
Organization Name: Costa Mesa Corp.
Primary Specialty: Dentist
Enumeration Date: Sep 12, 2008
Last Updated: Sep 12, 2008

Practice Location

Address: 230 E 17TH ST
Address 2: SUITE 208
City: Costa Mesa
State: California
ZIP Code: 92627-3824
Phone: (949) 645-0045

Authorized Official

Name: DR. RINESH GANATRA, D.D.S.
Title: OWNER
Phone: (949) 766-0006

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist	122300000X	Primary

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