| Lake Forest Oral Surgery | |
|
26700 Towne Centre Dr Ste 280 Foothill Ranch CA 92610-2844 | |
| (949) 203-3177 | |
| Not Available |
| Full Name | Lake Forest Oral Surgery |
|---|---|
| Speciality | Dentist - Oral And Maxillofacial Surgery |
| Location | 26700 Towne Centre Dr Ste 280, Foothill Ranch, California |
| Authorized Official Name and Position | Suzin UM (SURGEON) |
| Authorized Official Contact | 9492033177 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Lake Forest Oral Surgery 26700 Towne Centre Dr Ste 280 Foothill Ranch CA 92610-2844 Ph: (949) 203-3177 | Lake Forest Oral Surgery 26700 Towne Centre Dr Ste 280 Foothill Ranch CA 92610-2844 Ph: (949) 203-3177 |
| NPI Number | 1386203016 |
|---|---|
| Provider Enumeration Date | 06/06/2019 |
| Last Update Date | 06/06/2019 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1386203016 | NPI | - | NPPES |
| 64384 | Other | CA | CALIFORNIA DENTAL BOARD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223S0112X | Dentist - Oral And Maxillofacial Surgery | () | Primary |
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