Organization
BRINDHA SUBRAMANIAN, BDS, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN FEHMER (OFFICER)
(562) 577-5641
Entity
Organization
Contact information
Practice address
23082 RIDGE ROUTE DR STE A, LAKE FOREST, CA 92630-3691
(949) 837-2766
Mailing address
23082 RIDGE ROUTE DR STE A, LAKE FOREST, CA 92630-3691
(949) 837-2766
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
58339
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
58339
DENTAL BOARD OF CALIFORNIA
CA
Enumeration date
06/13/2018
Last updated
10/12/2022
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