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General NPI Number Information
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NPI Number | 1609912971
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Entity Type | Organization
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Legal Business Name | BAO LAN SUN DDS IINC
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Dates
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Enumeration Date | 01/30/2007
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Last Update Date | 01/12/2010
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Provider Practice Location Address
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Address Line | 23450 LYONS AVE
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City | NEWHALL
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State | CA
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Zip | 91321-5778
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Country | US
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Telephone | 661-799-8800
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Fax | 661-799-2805
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Provider Business Mailing Address
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Address Line | 23450 LYONS AVE
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City | NEWHALL
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State | CA
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Zip | 91321-5778
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Country | US
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Telephone | 661-799-8800
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Fax | 661-799-2805
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. BAO LAN SUN
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Credential | DDS
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Telephone | 661-799-8800
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number |
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License Number State |
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