Provider Demographics
NPI:1093809113
Name:JONSSON, LARS BJORN (DDS)
Entity Type:Individual
Prefix:DR
First Name:LARS
Middle Name:BJORN
Last Name:JONSSON
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:25261 PASEO DE VALENCIA
Mailing Address - Street 2:SUITE 3
Mailing Address - City:LAGUNA HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:92637-4966
Mailing Address - Country:US
Mailing Address - Phone:949-581-8890
Mailing Address - Fax:949-581-3902
Practice Address - Street 1:25261 PASEO DE VALENCIA
Practice Address - Street 2:SUITE 3
Practice Address - City:LAGUNA HILLS
Practice Address - State:CA
Practice Address - Zip Code:92637-4966
Practice Address - Country:US
Practice Address - Phone:949-581-8890
Practice Address - Fax:949-581-3902
Is Sole Proprietor?:No
Enumeration Date:2006-10-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA489241223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics