Provider Demographics
NPI:1457964215
Name:LARS BJORN JONSSON, D.D.S., M.S., INC.
Entity type:Organization
Organization Name:LARS BJORN JONSSON, D.D.S., M.S., INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:LARS
Authorized Official - Middle Name:BJORN
Authorized Official - Last Name:JONSSON
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:949-581-8890
Mailing Address - Street 1:25261 PASEO DE VALENCIA STE 3
Mailing Address - Street 2:
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:
Practice Address - Street 1:25261 PASEO DE VALENCIA STE 3
Practice Address - Street 2:
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:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-08-31
Last Update Date:2020-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223E0200XDental ProvidersDentistEndodonticsGroup - Single Specialty