| NPI | 1184834715 |
|---|---|
| Doing Business As | LAKE ELSINORE DENTAL GROUP |
| Entity Type | Organization |
| Authorized Contact | SOHEIL P LEVI Owner 951-674-6808 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice |
| Additional Taxonomies | 1223E0200X Dentist Endodontics |
| 1223P0300X Dentist Periodontics | |
| Enumeration Date | 2007-05-23 |
| Last Update Date | 2015-03-26 |