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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
JERRY L LANIER DDS (CEO/PRESIDENT)
(323) 461-9942
Entity
Organization
Contact information
Practice address
3015 CRENSHAW BLVD STE B, LOS ANGELES, CA 90016-4264
(323) 461-9942
Mailing address
4905 HOLLYWOOD BLVD, LOS ANGELES, CA 90027-6101
(323) 461-3342
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
02/15/2013
Last updated
02/15/2013
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