Organization
LE & LUU DENTAL CORP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. MERLIE A ROSALIN (OFFICE MANAGER)
(916) 691-1141
Entity
Organization
Contact information
Practice address
9575 LAGUNA SPRINGS DR, ELK GROVE, CA 95758-7961
(916) 691-1141
(916) 691-1119
Mailing address
9575 LAGUNA SPRINGS DR, ELK GROVE, CA 95758
(916) 691-1141
(916) 691-1119
Taxonomy
Speciality
Code
Description
License number
State
302F00000X
Exclusive Provider Organization
Primary
48953
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
48953
DENTAL LICENSE
CA
Enumeration date
05/28/2008
Last updated
07/05/2008
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