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Organization
SOUTHWEST DENTAL CENTER INC.
Active
Organization
SOUTHWEST DENTAL CENTER INC.
Active
Parent organization
SOUTHWEST DENTAL CENTER
Other names
HI DESERT DENTAL CENTER
Organization subpart
Yes
Provider details
NPI number
Legal business name
SOUTHWEST DENTAL CENTER
Authorized official
DR. LEONEED GORDON D.D.S (OWNER)
(661) 723-5400
Entity
Organization
Contact information
Practice address
1745 W AVENUE K, SUITE C, LANCASTER, CA 93534-6501
(661) 723-5400
(661) 723-3944
Mailing address
1745 W AVENUE K, SUITE C, LANCASTER, CA 93534-6501
(661) 723-5400
(661) 723-3944
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
32936
CA
1223G0001X
General Practice Dentistry
43266
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
32936
LICENSE
CA
01
—
43622
LICENSE
CA
01
—
571310977
GORDON
CA
Enumeration date
03/25/2009
Last updated
07/27/2016
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