| |
25200 La Paz Rd Ste 109 Laguna Hills CA 92653-5134 | |
(949) 855-9525 | |
(949) 707-3933 |
Full Name | |
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Speciality | Dentist |
Location | 25200 La Paz Rd Ste 109, Laguna Hills, California |
Authorized Official Name and Position | Lisa M Baeza (INSURANCE COORDINATOR) |
Authorized Official Contact | 9498559525 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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25200 La Paz Rd Ste 109 Laguna Hills CA 92653-5134 Ph: (949) 855-9525 | 25200 La Paz Rd Ste 109 Laguna Hills CA 92653-5134 Ph: (949) 855-9525 |
NPI Number | 1841577020 |
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Provider Enumeration Date | 11/15/2011 |
Last Update Date | 08/10/2016 |
Identifier | Type | State | Issuer |
---|---|---|---|
1841577020 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
122300000X | Dentist | 31169 (California) | Primary |
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