Lake Dental Office | |
930 N Lake Ave Pasadena CA 91104-4517 | |
(626) 791-5432 | |
(626) 791-5431 |
Full Name | Lake Dental Office |
---|---|
Speciality | Dentist |
Location | 930 N Lake Ave, Pasadena, California |
Authorized Official Name and Position | Trang-anh Mimie Nguyen (OWNER) |
Authorized Official Contact | 6267915432 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Lake Dental Office 930 N Lake Ave Pasadena CA 91104-4517 Ph: (626) 791-5432 | Lake Dental Office 930 N Lake Ave Pasadena CA 91104-4517 Ph: (626) 791-5432 |
NPI Number | 1194781252 |
---|---|
Provider Enumeration Date | 04/25/2006 |
Last Update Date | 09/23/2014 |
Identifier | Type | State | Issuer |
---|---|---|---|
1194781252 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
122300000X | Dentist | 44971 (California) | Primary |
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