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1745 W Avenue K Suite C Lancaster CA 93534-6501 | |
| (661) 723-5400 | |
| (661) 723-3944 |
| Full Name | |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 1745 W Avenue K, Lancaster, California |
| Authorized Official Name and Position | Leoneed Gordon (OWNER) |
| Authorized Official Contact | 6617235400 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
1745 W Avenue K Suite C Lancaster CA 93534-6501 Ph: (661) 723-5400 | 1745 W Avenue K Suite C Lancaster CA 93534-6501 Ph: (661) 723-5400 |
| NPI Number | 1942442777 |
|---|---|
| Provider Enumeration Date | 03/25/2009 |
| Last Update Date | 07/27/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1942442777 | NPI | - | NPPES |
| 32936 | Other | CA | LICENSE |
| 43622 | Other | CA | LICENSE |
| 571310977 | Other | CA | GORDON |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 32936 (California) | Primary |
| 1223G0001X | Dentist - General Practice | 43266 (California) | Secondary |
Romeo I. Stoll, Dds, Ms Inc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 1340 W Avenue J, Lancaster, CA 93534 Phone: 661-948-4674 | |
Western Dental Services, Inc. Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 44407 Challenger Way, Lancaster, CA 93535 Phone: 661-341-3100 Fax: 661-942-2305 | |
Bilal Shammout Dds Inc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 44215 15th St W Ste 313, Lancaster, CA 93534 Phone: 661-948-2721 Fax: 661-948-4055 | |
Bradford Boyd, Dds, Inc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 151 E Avenue J, Lancaster, CA 93535 Phone: 661-942-1179 |