| Anaheim Professional Dental Group | |
|
1834 W. Lincoln Ave. St. K Anaheim CA 92801 | |
| (714) 491-9264 | |
| (714) 491-7939 |
| Full Name | Anaheim Professional Dental Group |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 1834 W. Lincoln Ave. St. K, Anaheim, California |
| Authorized Official Name and Position | Dave Wang (CEO) |
| Authorized Official Contact | 7144919264 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Anaheim Professional Dental Group 1834 W. Lincoln Ave. St. K Anaheim CA 92801 Ph: (714) 491-9264 | Anaheim Professional Dental Group 1834 W. Lincoln Ave. St. K Anaheim CA 92801 Ph: (714) 491-9264 |
| NPI Number | 1669576013 |
|---|---|
| Provider Enumeration Date | 09/07/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1669576013 | NPI | - | NPPES |
| B44639-01 | Other | CA | MEDI-CAL, DENTI-CAL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 44639 (California) | Primary |
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