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Organization
LY DENTAL CORPORATION
Active
Organization
LY DENTAL CORPORATION
Active
Other names
Dr. Ly Vina Dental Group
Organization subpart
No
Provider details
NPI number
Authorized official
DR. QUY VAN LY DDS (PRESIDENT)
(714) 305-5199
Entity
Organization
Contact information
Practice address
9938 BOLSA AVE STE 106, WESTMINSTER, CA 92683-6039
(714) 305-5199
Mailing address
9938 BOLSA AVE STE 106, WESTMINSTER, CA 92683-6039
(714) 305-5199
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
40665
CA
Other
Enumeration date
09/14/2016
Last updated
09/14/2016
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