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Organization
LOC BAO, DDS, INC.
Active
Organization
LOC BAO, DDS, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LOC BAO DDS (PRESIDENT)
(619) 584-4015
Entity
Organization
Contact information
Practice address
4236 EL CAJON BLVD, SAN DIEGO, CA 92105-1230
(619) 584-4015
(619) 584-4016
Mailing address
4236 EL CAJON BLVD, SAN DIEGO, CA 92105-1230
(619) 584-4015
(619) 584-4016
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
44290
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
B44290-01
—
CA
Enumeration date
11/09/2006
Last updated
10/04/2011
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