| Dentists at Lakeside | |
|
2798 Pronio Circle Corona CA 92883 | |
| (951) 482-7093 | |
| (951) 547-0363 |
| Full Name | Dentists at Lakeside |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 2798 Pronio Circle, Corona, California |
| Authorized Official Name and Position | Jorge Enciso (OWNER) |
| Authorized Official Contact | 9514827093 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Dentists at Lakeside Po Box 660041 Dallas TX 75266-0041 Ph: (714) 845-8890 | Dentists at Lakeside 2798 Pronio Circle Corona CA 92883 Ph: (951) 482-7093 |
| NPI Number | 1467389460 |
|---|---|
| Provider Enumeration Date | 05/05/2026 |
| Last Update Date | 05/05/2026 |
| Certification Date | 04/30/2026 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1467389460 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (NU) | Primary |
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