| Bouquet Dental Inc | |
|
8003 Alicante Ave Lamont CA 93241-1712 | |
| (661) 845-2246 | |
| Not Available |
| Full Name | Bouquet Dental Inc |
|---|---|
| Speciality | Dentist |
| Location | 8003 Alicante Ave, Lamont, California |
| Authorized Official Name and Position | Soo T Park (PRESIDENT) |
| Authorized Official Contact | 6618452246 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Bouquet Dental Inc 8003 Alicante Ave Lamont CA 93241-1712 Ph: () - | Bouquet Dental Inc 8003 Alicante Ave Lamont CA 93241-1712 Ph: (661) 845-2246 |
| NPI Number | 1679044861 |
|---|---|
| Provider Enumeration Date | 12/16/2018 |
| Last Update Date | 12/16/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1679044861 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | (* (Not Available)) | Primary |
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