Organization
PHAN, RAWLINS & LYONS DDS INC
Active
Other names
Surfside Kids Dental
Organization subpart
No
Provider details
NPI number
Authorized official
JOSEPH RAWLINS DDS (PRESIDENT)
(916) 229-9941
Entity
Organization
Contact information
Practice address
6942 ALMADEN EXPY # 11, SAN JOSE, CA 95120-3201
(480) 235-8541
Mailing address
PO BOX 4785, EL DORADO HILLS, CA 95762-0024
(916) 229-9941
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
56958
CA
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
51968
CA
Other
Enumeration date
03/23/2016
Last updated
03/25/2016
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