| Juan Antonio Trejo Canchola Dental Corp | |
|
23030 Lake Forest Dr Suite 201 Laguna Hills CA 92653-1331 | |
| (949) 305-8242 | |
| (949) 305-8238 |
| Full Name | Juan Antonio Trejo Canchola Dental Corp |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 23030 Lake Forest Dr, Laguna Hills, California |
| Authorized Official Name and Position | Juan A Trejo Canchola (OWNER) |
| Authorized Official Contact | 9518420803 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Juan Antonio Trejo Canchola Dental Corp 9867 Magnolia Avenue Suite E Riverside CA 92503 Ph: (951) 352-2112 | Juan Antonio Trejo Canchola Dental Corp 23030 Lake Forest Dr Suite 201 Laguna Hills CA 92653-1331 Ph: (949) 305-8242 |
| NPI Number | 1689039570 |
|---|---|
| Provider Enumeration Date | 12/21/2015 |
| Last Update Date | 12/21/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1689039570 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 61049 (California) | Primary |
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