# LUMINA LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Mangilao Dental Clinic
- **Organization subpart:** No

## Provider details

- **NPI number:** 1003418369
- **Authorized official:** DR. SARAH LEE CLEGG DDS (OWNER)
- **Authorized official phone:** (510) 283-3460

## Contact information

- **Practice address:** 353 ROUTE 10 STE 101, MANGILAO, GU 96913-1392
- **Practice address phone:** (671) 969-4242
- **Mailing address:** PO BOX 9868, TAMUNING, GU 96931-5868
- **Mailing address phone:** (510) 283-3460

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QD0000X | Dental Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 11/12/2020
- **Last updated:** 11/13/2020