| Lakewood Dental & Orthodontics | |
|
4346 South St Lakewood CA 90712-1152 | |
| (562) 408-3500 | |
| (562) 408-3736 |
| Full Name | Lakewood Dental & Orthodontics |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 4346 South St, Lakewood, California |
| Authorized Official Name and Position | Faviola Silva (REGIONAL BILLING MANAGER) |
| Authorized Official Contact | 3238356839 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Lakewood Dental & Orthodontics 4346 South St Lakewood CA 90712-1152 Ph: (562) 408-3500 | Lakewood Dental & Orthodontics 4346 South St Lakewood CA 90712-1152 Ph: (562) 408-3500 |
| NPI Number | 1194487330 |
|---|---|
| Provider Enumeration Date | 10/05/2021 |
| Last Update Date | 10/05/2021 |
| Certification Date | 10/05/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1194487330 | NPI | - | NPPES |
| 1306984596 | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | (NU) | Primary |
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