| NPI | 1649648817 |
|---|---|
| Other Name | SOS - BEAUCHAMP DENTAL CENTER |
| Other Name | SOS - DR. ROBERT & DOROTHY BEAUCHAMP CHILDREN & FAMILY DENTAL CENTER |
| Entity Type | Organization |
| Authorized Contact | CHRISTY WARD CEO 949-536-3927 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Additional Taxonomies | 261QD0000X Clinic/Center, Dental |
| Enumeration Date | 2015-09-04 |
| Last Update Date | 2020-07-29 |