Organization
LY HO DENTAL CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LY HO DDS (PRESIDENT)
(310) 407-9909
Entity
Organization
Contact information
Practice address
420 S STATE COLLEGE BLVD, ANAHEIM, CA 92806-4119
(714) 772-0770
Mailing address
9651 HILLVIEW RD, ANAHEIM, CA 92804-3423
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1275814402
NPI TYPE 1
CA
01
—
60984
DENTAL BOARD LICENSE
CA
Enumeration date
09/14/2017
Last updated
09/14/2017
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