|
| |
|
1019 N Harbor Blvd Fullerton CA 92832-1310 | |
| (714) 992-0300 | |
| (714) 992-2724 |
| Full Name | |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 1019 N Harbor Blvd, Fullerton, California |
| Authorized Official Name and Position | Anna Khodadadeh Talmood (DOCTOR) |
| Authorized Official Contact | 7149920300 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
1019 N Harbor Blvd Fullerton CA 92832-1310 Ph: (714) 992-0300 | 1019 N Harbor Blvd Fullerton CA 92832-1310 Ph: (714) 992-0300 |
| NPI Number | 1114104452 |
|---|---|
| Provider Enumeration Date | 01/29/2008 |
| Last Update Date | 05/31/2017 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1114104452 | NPI | - | NPPES |
| D41931 | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | D41931 (California) | Primary |
Dr. Alice Skuben D.d.s. Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 170 N Raymond Ave, Fullerton, CA 92831 Phone: 714-870-2000 | |
United Dental Fullerton Corp Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 1961 W Malvern Ave Ste G, Fullerton, CA 92833 Phone: 714-525-6900 | |
Bom Jeon Dental Corp Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 1401 S Brookhurst Rd Ste 104, Fullerton, CA 92833 Phone: 714-879-2828 | |
Polina F Rhoudenko Dds Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 100 Laguna Rd Ste 210, Fullerton, CA 92835 Phone: 714-716-1783 | |