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38745 Tierra Subida Ave Suite 150 Palmdale CA 93551-4540 | |
(661) 272-9091 | |
(661) 272-4562 |
Full Name | |
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Speciality | Dentist |
Location | 38745 Tierra Subida Ave, Palmdale, California |
Authorized Official Name and Position | Elaine Salcido (CONTRACT SUPERVISOR) |
Authorized Official Contact | 7147085308 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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2 Macarthur Pl Suite 700 Santa Ana CA 92707-5924 Ph: (714) 708-5308 | 38745 Tierra Subida Ave Suite 150 Palmdale CA 93551-4540 Ph: (661) 272-9091 |
NPI Number | 1366514960 |
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Provider Enumeration Date | 11/15/2006 |
Last Update Date | 08/22/2020 |
Identifier | Type | State | Issuer |
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1366514960 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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122300000X | Dentist | (* (Not Available)) | Primary |