FOUNTAIN MODERN DENTISTRY AND ORTHODONTICS, LLP is a general practice dentist in Irvine, CA. The provider is a general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs. FOUNTAIN MODERN DENTISTRY AND ORTHODONTICS, LLP NPI is 1730434622. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As Fountain Modern Dentistry And Orthodontics.
The provider's business location address is:
2860 MICHELLE DRIVE 2ND FLOOR
IRVINE, CA
ZIP 92606
Phone: (714) 368-2077
Fax: (714) 368-2092
The provider's authorized official is Charles Rodgers .
The authorized official title is Dds/ Owner and has the following contact phone number (719) 382-4936.
The CLIA number assigned to this NPI record is 06D2144174 - physician office with a certificate type of Certificate of Waiver.
The enumeration date for this NPI number is 7/17/2012 and was last updated on 7/17/2012.