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Organization
GOWDA PROFESSIONAL DENTAL INC
Active
Organization
GOWDA PROFESSIONAL DENTAL INC
Active
Other names
Lakeshore Family Dentistry
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ROOPA S GOWDA D.D.S. (PRESIDENT)
(951) 522-5492
Entity
Organization
Contact information
Practice address
16738 LAKESHORE DR STE D, LAKE ELSINORE, CA 92530-4933
(951) 245-7374
(951) 245-6525
Mailing address
16738 LAKESHORE DR STE D, LAKE ELSINORE, CA 92530-4933
(951) 245-7374
(951) 245-6525
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
CA
Other
Enumeration date
04/18/2007
Last updated
11/02/2016
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