| |
1651 E Orangethorpe Ave Placentia CA 92870-6629 | |
(714) 993-2768 | |
(714) 993-2775 |
Full Name | |
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Speciality | Dentist - General Practice |
Location | 1651 E Orangethorpe Ave, Placentia, California |
Authorized Official Name and Position | Jose Eduardo Lara (PRESIDENT) |
Authorized Official Contact | 7149932768 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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1651 E Orangethorpe Ave Placentia CA 92870-6629 Ph: (714) 993-2768 | 1651 E Orangethorpe Ave Placentia CA 92870-6629 Ph: (714) 993-2768 |
NPI Number | 1952461725 |
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Provider Enumeration Date | 12/11/2006 |
Last Update Date | 06/23/2016 |
Identifier | Type | State | Issuer |
---|---|---|---|
1952461725 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
1223G0001X | Dentist - General Practice | 44205 (California) | Primary |
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