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2400 West Lincon Ave Anaheim CA 92801-9280 | |
| (818) 665-8999 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 2400 West Lincon Ave, Anaheim, California |
| Authorized Official Name and Position | Cristina T. Avancena (OFFICE MANAGER) |
| Authorized Official Contact | 8186658999 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
2400 W Lincoln Ave Anaheim CA 92801-6401 Ph: () - | 2400 West Lincon Ave Anaheim CA 92801-9280 Ph: (818) 665-8999 |
| NPI Number | 1861974693 |
|---|---|
| Provider Enumeration Date | 08/29/2018 |
| Last Update Date | 08/29/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1861974693 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | 50084 (California) | Primary |
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