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1501 Superior Ave Suite #100 Newport Beach CA 92663 | |
| (949) 650-6772 | |
| (949) 645-5701 |
| Full Name | |
|---|---|
| Speciality | Dentist |
| Location | 1501 Superior Ave, Newport Beach, California |
| Authorized Official Name and Position | Lannder R. Gil (INSURANCE COORDINATOR) |
| Authorized Official Contact | 9496506772 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
1501 Superior Ave Suite #100 Newport Beach CA 92663 Ph: (949) 650-6772 | 1501 Superior Ave Suite #100 Newport Beach CA 92663 Ph: (949) 650-6772 |
| NPI Number | 1780721050 |
|---|---|
| Provider Enumeration Date | 01/30/2007 |
| Last Update Date | 06/11/2019 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1780721050 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 43161 (California) | Primary |
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