Organization
SUZIN UM DDS, INC
Active
Other names
Lake Forest Oral Surgery
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SUZIN UM DDS (SURGEON)
(949) 203-3177
Entity
Organization
Contact information
Practice address
26700 TOWNE CENTRE DR STE 280, FOOTHILL RANCH, CA 92610-2844
(949) 203-3177
Mailing address
26700 TOWNE CENTRE DR STE 280, FOOTHILL RANCH, CA 92610-2844
(949) 203-3177
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
64384
CALIFORNIA DENTAL BOARD
CA
Enumeration date
06/06/2019
Last updated
06/06/2019
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