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2710 Carson St Lakewood CA 90712-4051 | |
| (562) 275-8113 | |
| (562) 247-9830 |
| Full Name | |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 2710 Carson St, Lakewood, California |
| Authorized Official Name and Position | Jessica L Leong (OWNER) |
| Authorized Official Contact | 5622758113 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
Po Box 920050 Dallas TX 75392-0050 Ph: (714) 845-8890 | 2710 Carson St Lakewood CA 90712-4051 Ph: (562) 275-8113 |
| NPI Number | 1265082366 |
|---|---|
| Provider Enumeration Date | 09/19/2019 |
| Last Update Date | 03/08/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1265082366 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
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