Most Relevant Information
Provider Data
| NPI Number: | 1003807199 |
| Provider Name: | GEORGE W BRAZEAL D.D.S. |
| Entity Type: | Individual |
| Taxonomy Code: | 122300000X |
| Specialty: | Dentist |
| License Number: | 26591 |
Most Important Dates
| Enumeration Date: | 10/29/2005 |
| Last Updated: | 08/07/2007 |
Provider Practice Location
2345 E COAST HWY
SUITE B
CORONA DEL MAR
CA
926252034
Practice Location Phone/Fax
| Phone: | 9496736443 |
| Fax: |
Provider Mailing Location
2345 E COAST HWY
SUITE B
CORONA DEL MAR
CA
926252034
Provider Mailing Phone/Fax
| Phone: | 9496736443 |
| Fax: |