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Organization
DENTISTS AT LAKESIDE, PROF. CORP.
Active
Organization
DENTISTS AT LAKESIDE, PROF. CORP.
Active
Other names
Dentists at Lakeside
Organization subpart
No
Provider details
NPI number
Authorized official
JORGE ENCISO DDS (OWNER)
(951) 482-7093
Entity
Organization
Contact information
Practice address
2798 PRONIO CIRCLE, CORONA, CA 92883
(951) 482-7093
(951) 547-0363
Mailing address
PO BOX 660041, DALLAS, TX 75266-0041
(714) 845-8890
(303) 952-0892
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
05/05/2026
Last updated
05/05/2026
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