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18285 Collier Ave. Ste. B Lake Elsinore CA 92530 | |
| (951) 471-0034 | |
| (951) 471-0166 |
| Full Name | |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 18285 Collier Ave., Lake Elsinore, California |
| Authorized Official Name and Position | Bryan K Watanabe (OWNER DDS) |
| Authorized Official Contact | 9514710034 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
2860 Michelle 2nd Floor Irvine CA 92606-1009 Ph: (714) 508-3600 | 18285 Collier Ave. Ste. B Lake Elsinore CA 92530 Ph: (951) 471-0034 |
| NPI Number | 1952465148 |
|---|---|
| Provider Enumeration Date | 12/21/2006 |
| Last Update Date | 06/03/2009 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1952465148 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
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