| Lake Jackson Modern Dentistry | |
|
17000 Red Hill Ave Irvine CA 92614-5626 | |
| (714) 845-8890 | |
| (949) 474-1495 |
| Full Name | Lake Jackson Modern Dentistry |
|---|---|
| Speciality | Dentist |
| Location | 17000 Red Hill Ave, Irvine, California |
| Authorized Official Name and Position | John S Barnes (OWNER DOCTOR) |
| Authorized Official Contact | 9795836005 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Lake Jackson Modern Dentistry 97 Oyster Creek Dr Suite 130 Lake Jackson TX 77566 Ph: (979) 583-6005 | Lake Jackson Modern Dentistry 17000 Red Hill Ave Irvine CA 92614-5626 Ph: (714) 845-8890 |
| NPI Number | 1821472507 |
|---|---|
| Provider Enumeration Date | 07/13/2015 |
| Last Update Date | 07/13/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1821472507 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | (* (Not Available)) | Primary |
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