Organization
MICHAEL VINCENT LAUREOLA DDS INC
Active
Other names
MAGICLAND DENTAL GROUP OF MORENO VALLEY
Organization subpart
No
Provider details
NPI number
Authorized official
MIGUEL REYES (Q/A CONTRACT & COMPLIANCE MANAGER)
(310) 409-4225
Entity
Organization
Contact information
Practice address
2862 UNIT A CANYON SPRINGS PARKWAY, RIVERSIDE, CA 92507
(951) 214-4994
(951) 214-4995
Mailing address
12121 WILSHIRE BLVD STE 1111, LOS ANGELES, CA 90025-1188
(310) 820-9933
(310) 820-0408
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
—
—
Other
Enumeration date
07/31/2020
Last updated
07/31/2020
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