Provider Demographics
NPI:1063622371
Name:LO, JONATHAN H (DDS)
Entity type:Individual
Prefix:DR
First Name:JONATHAN
Middle Name:H
Last Name:LO
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Gender:M
Credentials:DDS
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Mailing Address - Street 1:550 DEEP VALLEY DR
Mailing Address - Street 2:SUITE 345
Mailing Address - City:ROLLING HILLS ESTATES
Mailing Address - State:CA
Mailing Address - Zip Code:90274-3664
Mailing Address - Country:US
Mailing Address - Phone:310-377-4551
Mailing Address - Fax:310-541-6042
Practice Address - Street 1:550 DEEP VALLEY DR
Practice Address - Street 2:SUITE 345
Practice Address - City:ROLLING HILLS ESTATES
Practice Address - State:CA
Practice Address - Zip Code:90274-3664
Practice Address - Country:US
Practice Address - Phone:310-377-4551
Practice Address - Fax:310-541-6042
Is Sole Proprietor?:No
Enumeration Date:2007-05-23
Last Update Date:2021-11-03
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Provider Licenses
StateLicense IDTaxonomies
CA549261223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry