| NPI | 1568286896 |
|---|---|
| Doing Business As | BLUE LAKE DENTAL |
| Entity Type | Organization |
| Authorized Contact | VU HUY DANG Dentist/Owner 714-260-4040 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice |
| Enumeration Date | 2024-11-13 |
| Last Update Date | 2024-11-13 |