Ly Ho Dental Corporation | |
420 S State College Blvd Anaheim CA 92806-4119 | |
(714) 772-0770 | |
Not Available |
Full Name | Ly Ho Dental Corporation |
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Speciality | Clinic/center - Dental |
Location | 420 S State College Blvd, Anaheim, California |
Authorized Official Name and Position | Ly Ho (PRESIDENT) |
Authorized Official Contact | 3104079909 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Ly Ho Dental Corporation 9651 Hillview Rd Anaheim CA 92804-3423 Ph: () - | Ly Ho Dental Corporation 420 S State College Blvd Anaheim CA 92806-4119 Ph: (714) 772-0770 |
NPI Number | 1639698277 |
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Provider Enumeration Date | 09/14/2017 |
Last Update Date | 09/14/2017 |
Identifier | Type | State | Issuer |
---|---|---|---|
1639698277 | NPI | - | NPPES |
1275814402 | Other | CA | NPI TYPE 1 |
60984 | Other | CA | DENTAL BOARD LICENSE |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QD0000X | Clinic/center - Dental | (California) | Primary |
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