Lekavich Dental Corporation | |
217 Palos Verdes Blvd #105 Redondo Beach CA 90277-5820 | |
(310) 373-5616 | |
(310) 872-5459 |
Full Name | Lekavich Dental Corporation |
---|---|
Speciality | Dentist |
Location | 217 Palos Verdes Blvd, Redondo Beach, California |
Authorized Official Name and Position | Timothy Floran Lekavich (PRESIDENT) |
Authorized Official Contact | 3103735616 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Lekavich Dental Corporation 217 Palos Verdes Blvd #105 Redondo Beach CA 90277-5820 Ph: (310) 373-5616 | Lekavich Dental Corporation 217 Palos Verdes Blvd #105 Redondo Beach CA 90277-5820 Ph: (310) 373-5616 |
NPI Number | 1013118686 |
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Provider Enumeration Date | 05/30/2007 |
Last Update Date | 10/03/2007 |
Identifier | Type | State | Issuer |
---|---|---|---|
1013118686 | NPI | - | NPPES |
G89891-01 | Medicaid | CA |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
122300000X | Dentist | 38866 (California) | Primary |
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