| Goodland Children's Dentistry | |
|
1111 E Ocean Ave Ste 4b Lompoc CA 93436-2500 | |
| (805) 456-2866 | |
| (805) 456-0350 |
| Full Name | Goodland Children's Dentistry |
|---|---|
| Speciality | Dentist - Pediatric Dentistry |
| Location | 1111 E Ocean Ave Ste 4b, Lompoc, California |
| Authorized Official Name and Position | Stephanie Trahan (CEO) |
| Authorized Official Contact | 8054562866 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Goodland Children's Dentistry 1111 E Ocean Ave Ste 4b Lompoc CA 93436-2500 Ph: (805) 456-2866 | Goodland Children's Dentistry 1111 E Ocean Ave Ste 4b Lompoc CA 93436-2500 Ph: (805) 456-2866 |
| NPI Number | 1760254239 |
|---|---|
| Provider Enumeration Date | 10/26/2023 |
| Last Update Date | 10/26/2023 |
| Certification Date | 10/26/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1760254239 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0221X | Dentist - Pediatric Dentistry | (NU) | Primary |
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