Provider Demographics
NPI:1083264774
Name:LISA A. HOU, DDS, MS DENTAL GROUP
Entity Type:Organization
Organization Name:LISA A. HOU, DDS, MS DENTAL GROUP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:LISA
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:HOU
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:213-219-2852
Mailing Address - Street 1:4280 VIA ARBOLADA UNIT 220
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90042-5088
Mailing Address - Country:US
Mailing Address - Phone:213-219-2852
Mailing Address - Fax:626-872-6177
Practice Address - Street 1:1212 S GARFIELD AVE
Practice Address - Street 2:
Practice Address - City:ALHAMBRA
Practice Address - State:CA
Practice Address - Zip Code:91801-5036
Practice Address - Country:US
Practice Address - Phone:626-872-1678
Practice Address - Fax:626-872-6177
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-09-16
Last Update Date:2019-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty