Organization
MLD DENTAL INC
Active
Other names
Chapman Smiles Center
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MATHEW T LUU DDS (DENTIST)
(714) 261-4243
Entity
Organization
Contact information
Practice address
9448 MAGNOLIA AVE, RIVERSIDE, CA 92503-3700
(951) 343-0123
(714) 984-0246
Mailing address
2140 W CHAPMAN AVE STE 107, ORANGE, CA 92868-2331
(714) 829-5489
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
49141
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
G9363301
—
CA
Enumeration date
09/29/2017
Last updated
09/29/2017
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