| Lake Dental Office | |
|
930 N Lake Ave Pasadena CA 91104-4517 | |
| (626) 791-5432 | |
| (626) 791-5431 |
| Full Name | Lake Dental Office |
|---|---|
| Speciality | Dentist |
| Location | 930 N Lake Ave, Pasadena, California |
| Authorized Official Name and Position | Trang-anh Mimie Nguyen (OWNER) |
| Authorized Official Contact | 6267915432 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Lake Dental Office 930 N Lake Ave Pasadena CA 91104-4517 Ph: (626) 791-5432 | Lake Dental Office 930 N Lake Ave Pasadena CA 91104-4517 Ph: (626) 791-5432 |
| NPI Number | 1194781252 |
|---|---|
| Provider Enumeration Date | 04/25/2006 |
| Last Update Date | 09/23/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1194781252 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 44971 (California) | Primary |
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