| Brindha Subramanian, Bds, Inc. | |
|
23082 Ridge Route Dr Ste A Lake Forest CA 92630-3691 | |
| (949) 837-2766 | |
| Not Available |
| Full Name | Brindha Subramanian, Bds, Inc. |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 23082 Ridge Route Dr Ste A, Lake Forest, California |
| Authorized Official Name and Position | John Fehmer (OFFICER) |
| Authorized Official Contact | 5625775641 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Brindha Subramanian, Bds, Inc. 23082 Ridge Route Dr Ste A Lake Forest CA 92630-3691 Ph: (949) 837-2766 | Brindha Subramanian, Bds, Inc. 23082 Ridge Route Dr Ste A Lake Forest CA 92630-3691 Ph: (949) 837-2766 |
| NPI Number | 1669965604 |
|---|---|
| Provider Enumeration Date | 06/13/2018 |
| Last Update Date | 10/12/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1669965604 | NPI | - | NPPES |
| 58339 | Other | CA | DENTAL BOARD OF CALIFORNIA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 58339 (California) | Primary |
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