| Hi-desert Dental Center | |
|
2205 E Palmdale Blvd Palmdale CA 93550-1316 | |
| (661) 273-1333 | |
| (661) 273-1687 |
| Full Name | Hi-desert Dental Center |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 2205 E Palmdale Blvd, Palmdale, California |
| Authorized Official Name and Position | Leoneed Gordon (PRESIDENT CEO) |
| Authorized Official Contact | 6612731333 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Hi-desert Dental Center 2205 E Palmdale Blvd Palmdale CA 93550-1316 Ph: (661) 273-1333 | Hi-desert Dental Center 2205 E Palmdale Blvd Palmdale CA 93550-1316 Ph: (661) 273-1333 |
| NPI Number | 1013134808 |
|---|---|
| Provider Enumeration Date | 04/20/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1013134808 | NPI | - | NPPES |
| 43622 | Other | CA | DENTIST |
| 32936 | Other | CA | DENTIST |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 32936 (California) | Secondary |
| 1223G0001X | Dentist - General Practice | 43266 (California) | Primary |
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