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31500 Grape St Ste 8 Lake Elsinore CA 92532-9702 | |
(951) 471-1628 | |
(951) 471-1638 |
Full Name | |
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Speciality | Dentist |
Location | 31500 Grape St Ste 8, Lake Elsinore, California |
Authorized Official Name and Position | Barouir Deirmenjian (CEO) |
Authorized Official Contact | 3109236981 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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260 S Glendora Ave 2nd Floor West Covina CA 91790-3041 Ph: (626) 214-1900 | 31500 Grape St Ste 8 Lake Elsinore CA 92532-9702 Ph: (951) 471-1628 |
NPI Number | 1568680700 |
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Provider Enumeration Date | 04/23/2007 |
Last Update Date | 08/03/2011 |
Identifier | Type | State | Issuer |
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1568680700 | NPI | - | NPPES |
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