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Organization
JERRY L LANIER DDS INC.
Active
Organization
JERRY L LANIER DDS INC.
Active
Other names
Kids Dental Kare
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JERRY LANIER DDS (PRESIDENT/DENTIST)
(310) 632-0202
Entity
Organization
Contact information
Practice address
10900 LONG BEACH BLVD, LYNWOOD, CA 90262-2688
(310) 632-0202
Mailing address
10900 LONG BEACH BLVD, LYNWOOD, CA 90262-2688
(310) 632-0202
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
40088
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1356489660
—
CA
Enumeration date
05/01/2009
Last updated
05/01/2009
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