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32235 Mission Trail # 8 Lake Elsinore CA 92530 | |
| (951) 674-6808 | |
| (951) 674-2668 |
| Full Name | |
|---|---|
| Speciality | Dentist |
| Location | 32235 Mission Trail # 8, Lake Elsinore, California |
| Authorized Official Name and Position | Roya E Levi (OWNER) |
| Authorized Official Contact | 9516777779 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
32235 Mission # 8 Lake Elsinore CA 92530 Ph: (951) 674-6808 | 32235 Mission Trail # 8 Lake Elsinore CA 92530 Ph: (951) 674-6808 |
| NPI Number | 1952825648 |
|---|---|
| Provider Enumeration Date | 08/03/2017 |
| Last Update Date | 08/03/2017 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1952825648 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 29257 (California) | Primary |
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