| Lake Forest Pediatric Dentistry | |
|
2674 San Miguel Dr Newport Beach CA 92660-5437 | |
| (949) 478-6628 | |
| Not Available |
| Full Name | Lake Forest Pediatric Dentistry |
|---|---|
| Speciality | Dentist - Pediatric Dentistry |
| Location | 2674 San Miguel Dr, Newport Beach, California |
| Authorized Official Name and Position | Keith H Tam (OWNER, DDS) |
| Authorized Official Contact | 9493229778 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Lake Forest Pediatric Dentistry 2674 San Miguel Dr Ste C Newport Beach CA 92660-5437 Ph: (949) 478-6628 | Lake Forest Pediatric Dentistry 2674 San Miguel Dr Newport Beach CA 92660-5437 Ph: (949) 478-6628 |
| NPI Number | 1497009831 |
|---|---|
| Provider Enumeration Date | 11/07/2012 |
| Last Update Date | 01/27/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1497009831 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0221X | Dentist - Pediatric Dentistry | 57293 (California) | Primary |
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