| 123 Smile Dental Care | |
|
1641 E 17th St Suite B Santa Ana CA 92705-8535 | |
| (714) 542-7400 | |
| (714) 543-3536 |
| Full Name | 123 Smile Dental Care |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 1641 E 17th St, Santa Ana, California |
| Authorized Official Name and Position | Quynh-tram Thi Truong (CEO) |
| Authorized Official Contact | 7145427400 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| 123 Smile Dental Care 1641 E 17th St Suite B Santa Ana CA 92705-8535 Ph: (714) 542-7400 | 123 Smile Dental Care 1641 E 17th St Suite B Santa Ana CA 92705-8535 Ph: (714) 542-7400 |
| NPI Number | 1073733697 |
|---|---|
| Provider Enumeration Date | 04/26/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1073733697 | NPI | - | NPPES |
| G93018 | Other | CA | DENTI-CAL ID NUMBER |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 47426 (California) | Primary |
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