| Lumina Llc | |
|
353 Route 10 Ste 101 Mangilao GU 96913-1392 | |
| (671) 969-4242 | |
| Not Available |
| Full Name | Lumina Llc |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 353 Route 10 Ste 101, Mangilao, Guam |
| Authorized Official Name and Position | Sarah Lee Clegg (OWNER) |
| Authorized Official Contact | 5102833460 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Lumina Llc Po Box 9868 Tamuning GU 96931-5868 Ph: (510) 283-3460 | Lumina Llc 353 Route 10 Ste 101 Mangilao GU 96913-1392 Ph: (671) 969-4242 |
| NPI Number | 1003418369 |
|---|---|
| Provider Enumeration Date | 11/12/2020 |
| Last Update Date | 11/13/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1003418369 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | (* (Not Available)) | Primary |