Organization
LW INC
Active
Other names
Mission Viejo Dental Asociates
Organization subpart
No
Provider details
NPI number
Authorized official
ELISA KIELY (OFFICE ADMISTRATOR)
(949) 586-6200
Entity
Organization
Contact information
Practice address
25522 MARGUERITE PARKWAY, SUITE #100, MISSION VIEJO, CA 92692
(949) 586-6200
(949) 586-2791
Mailing address
25522 MARGUERITE PKWY, STE #100, MISSION VIEJO, CA 92692
(949) 586-6200
(949) 586-2791
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
21292
CA
Other
Enumeration date
06/12/2008
Last updated
06/12/2008
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