NPI | 1497009831 |
---|---|
Doing Business As | LAKE FOREST PEDIATRIC DENTISTRY |
Entity Type | Organization |
Authorized Contact | KEITH H TAM Owner, Dds 949-322-9778 |
Organization Subpart ? | Yes |
Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: CA 57293) |
Enumeration Date | 2012-11-07 |
Last Update Date | 2022-01-27 |