| Bom Seok Jeon, Dds, Inc | |
|
1401 S Brookhurst Rd Ste 104 Fullerton CA 92833-4492 | |
| (714) 879-2828 | |
| Not Available |
| Full Name | Bom Seok Jeon, Dds, Inc |
|---|---|
| Speciality | Dentist |
| Location | 1401 S Brookhurst Rd Ste 104, Fullerton, California |
| Authorized Official Name and Position | Bom Seok Jeon (PRESIDENT) |
| Authorized Official Contact | 2137005090 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Bom Seok Jeon, Dds, Inc 1401 S Brookhurst Rd Ste 104 Fullerton CA 92833-4492 Ph: (714) 879-2828 | Bom Seok Jeon, Dds, Inc 1401 S Brookhurst Rd Ste 104 Fullerton CA 92833-4492 Ph: (714) 879-2828 |
| NPI Number | 1780030304 |
|---|---|
| Provider Enumeration Date | 05/12/2016 |
| Last Update Date | 05/12/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1780030304 | NPI | - | NPPES |
| 1295175859 | Other | CA | DENTICAL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 62451 (California) | Primary |
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