| Lakeshore Village Dental Group | |
|
23581 Sunnymead Ranch Pkwy Ste 124 Moreno Valley CA 92557-2868 | |
| (951) 601-1000 | |
| (951) 601-3519 |
| Full Name | Lakeshore Village Dental Group |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 23581 Sunnymead Ranch Pkwy Ste 124, Moreno Valley, California |
| Authorized Official Name and Position | Makbulahmed I Patel (SECRETARY) |
| Authorized Official Contact | 9516011000 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Lakeshore Village Dental Group 23581 Sunnymead Ranch Pkwy Ste 124 Moreno Valley CA 92557-2868 Ph: (951) 601-1000 | Lakeshore Village Dental Group 23581 Sunnymead Ranch Pkwy Ste 124 Moreno Valley CA 92557-2868 Ph: (951) 601-1000 |
| NPI Number | 1851501795 |
|---|---|
| Provider Enumeration Date | 05/22/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1851501795 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 37000 (California) | Primary |
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