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General NPI Number Information
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NPI Number | 1891066262
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Entity Type | Organization
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Legal Business Name | DAO REFELA DENTAL PARTNERSHIP
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Dates
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Enumeration Date | 01/18/2012
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Last Update Date | 01/18/2012
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Provider Practice Location Address
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Address Line | 831 E HUNTINGTON DR STE 201
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City | MONROVIA
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State | CA
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Zip | 91016-3612
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Country | US
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Telephone | 626-359-8300
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Fax | 626-359-8311
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Provider Business Mailing Address
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Address Line | 831 E HUNTINGTON DR STE 201
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City | MONROVIA
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State | CA
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Zip | 91016-3612
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Country | US
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Telephone | 626-359-8300
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Fax | 626-359-8311
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Authorized Official
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Title or Position | OWNER
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Name | DR. LAN B DAO
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Credential | D.D.S.
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Telephone | 310-699-0775
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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 | 59625
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 53902
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License Number State | CA
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