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5507 Woodruff Ave Lakewood CA 90713-1534 | |
| (562) 920-9050 | |
| (562) 920-9057 |
| Full Name | |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 5507 Woodruff Ave, Lakewood, California |
| Authorized Official Name and Position | Christy Ha Thai (CEO) |
| Authorized Official Contact | 5629209050 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
5507 Woodruff Ave Lakewood CA 90713-1534 Ph: (562) 920-9050 | 5507 Woodruff Ave Lakewood CA 90713-1534 Ph: (562) 920-9050 |
| NPI Number | 1417228263 |
|---|---|
| Provider Enumeration Date | 01/25/2012 |
| Last Update Date | 03/15/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1417228263 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 47571 (California) | Primary |
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