Organization
LUMINA LLC
Active
Other names
Mangilao Dental Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SARAH LEE CLEGG DDS (OWNER)
(510) 283-3460
Entity
Organization
Contact information
Practice address
353 ROUTE 10 STE 101, MANGILAO, GU 96913-1392
(671) 969-4242
Mailing address
PO BOX 9868, TAMUNING, GU 96931-5868
(510) 283-3460
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
11/12/2020
Last updated
11/13/2020
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