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Organization
LIN MA DDS INC
Active
Organization
LIN MA DDS INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROSA I NORIEGA (OFFICE MANAGER)
(626) 966-4514
Entity
Organization
Contact information
Practice address
358 N AZUSA AVE, WEST COVINA, CA 91791-1352
(626) 966-4514
Mailing address
358 N AZUSA AVE, WEST COVINA, CA 91791-1352
(626) 966-4514
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
46201
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
G9279001
—
CA
Enumeration date
07/05/2007
Last updated
08/22/2020
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