| Lollipop Pediatric Dentistry & Orthodontics | |
|
13931 Carroll Way Ste C Tustin CA 92780-1861 | |
| (714) 528-8252 | |
| Not Available |
| Full Name | Lollipop Pediatric Dentistry & Orthodontics |
|---|---|
| Speciality | Dentist - Pediatric Dentistry |
| Location | 13931 Carroll Way Ste C, Tustin, California |
| Authorized Official Name and Position | Mary Regina Pham (CEO PEDIATRIC DENTIST) |
| Authorized Official Contact | 7145288252 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Lollipop Pediatric Dentistry & Orthodontics 2750 Harbor Blvd Ste B6 Costa Mesa CA 92626-5121 Ph: (714) 528-8252 | Lollipop Pediatric Dentistry & Orthodontics 13931 Carroll Way Ste C Tustin CA 92780-1861 Ph: (714) 528-8252 |
| NPI Number | 1245827377 |
|---|---|
| Provider Enumeration Date | 12/22/2020 |
| Last Update Date | 02/03/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1245827377 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0221X | Dentist - Pediatric Dentistry | (* (Not Available)) | Primary |
| 1223X0400X | Dentist - Orthodontics And Dentofacial Orthopedics | (* (Not Available)) | Secondary |
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