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NPI Code Detail

MEDICARE: DR. CAITLIN JEAN LANZON D.D.S., M.S.

MEDICARE:  DR. CAITLIN JEAN LANZON  D.D.S., M.S.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1122300000XDentist65049CA

General Provider Information

NPI Number : 1184091688
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. CAITLIN JEAN LANZON D.D.S., M.S.
Provider Business Mailing Address
First Line : 5249 MISSION OAKS BLVD
Second Line :
City : CAMARILLO
State : CA
Zip : 93012-5403
Country : US
Telephone Number : 805-987-0245
Fax Number :
Provider Business Practice Location Address
First Line : 5249 MISSION OAKS BLVD
Second Line :
City : CAMARILLO
State : CA
Zip : 93012-5403
Country : US
Telephone Number : 805-987-0245
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/01/2015
Last Update Date : 02/28/2017

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Directions to “ DR. CAITLIN JEAN LANZON D.D.S., M.S.” Practice Location

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