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Organization
LEKAVICH DENTAL CORPORATION
Active
Organization
LEKAVICH DENTAL CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TIMOTHY FLORAN LEKAVICH D.D.S. (PRESIDENT)
(310) 373-5616
Entity
Organization
Contact information
Practice address
217 PALOS VERDES BLVD, #105, REDONDO BEACH, CA 90277-5820
(310) 373-5616
(310) 872-5459
Mailing address
217 PALOS VERDES BLVD, #105, REDONDO BEACH, CA 90277-5820
(310) 373-5616
(310) 872-5459
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
38866
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
G89891-01
—
CA
Enumeration date
05/30/2007
Last updated
10/03/2007
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