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General NPI Number Information
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NPI Number | 1730740697
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Entity Type | Organization
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Legal Business Name | LUONG LEE DENTAL PARTNERSHIP
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Dates
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Enumeration Date | 06/21/2019
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Last Update Date | 06/21/2019
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Provider Practice Location Address
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Address Line | 5753 E SANTA ANA CANYON RD STE K
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City | ANAHEIM
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State | CA
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Zip | 92807-3230
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Country | US
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Telephone | 714-998-4700
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Fax |
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Provider Business Mailing Address
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Address Line | 5753 E SANTA ANA CANYON RD STE K
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City | ANAHEIM
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State | CA
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Zip | 92807-3230
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Country | US
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Telephone | 714-366-2032
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Fax |
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Authorized Official
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Title or Position | ORTHODONTIST PARTNER
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Name | BRIAN LUONG
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Credential | DMD MBA MS
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Telephone | 714-366-2032
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number |
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License Number State |
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