Brindha Subramanian, Bds, INC.
Dentist, General Practice in Lake Forest, CA. Organization (NPI-2).
NPI number1669965604
StatusActive
Last updated in NPPESOct 12, 2022
Details
- NPI
- 1669965604
- Entity type
- Organization (NPI-2)
- Legal business name
- Brindha Subramanian, Bds, INC.
- Organization subpart
- No
- Enumeration date
- Jun 13, 2018
- Certification date
- Oct 12, 2022
- Last updated
- Oct 12, 2022
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 1223G0001X | Dentist, General Practice | 58339 | CA | Yes |
Practice location
23082 Ridge Route Dr Ste ALake Forest, CA 92630-3691
Phone 949-837-2766
Mailing address
23082 Ridge Route Dr Ste ALake Forest, CA 92630-3691
Phone 949-837-2766
Authorized official
John Fehmer
Officer
5625775641
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