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General NPI Number Information
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NPI Number | 1154690071
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Entity Type | Organization
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Legal Business Name | L.J. OAKES DDS, INC.
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Dates
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Enumeration Date | 12/21/2011
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Last Update Date | 12/21/2011
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Provider Practice Location Address
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Address Line | 720 E LATHAM AVE STE 3
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City | HEMET
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State | CA
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Zip | 92543-4371
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Country | US
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Telephone | 951-766-4211
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Fax | 951-766-4210
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Provider Business Mailing Address
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Address Line | 720 E LATHAM AVE STE 3
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City | HEMET
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State | CA
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Zip | 92543-4371
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Country | US
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Telephone | 951-766-4211
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Fax | 951-766-4210
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Authorized Official
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Title or Position | DENTIST/OWNER
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Name | LAWRENCE J OAKES
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Credential | DDS
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Telephone | 951-766-4211
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 21181
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License Number State | MN
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