First Dental Care | |
2801 W Ball Rd #10 Anaheim CA 92804-4900 | |
(714) 527-5656 | |
(714) 527-7412 |
Full Name | First Dental Care |
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Speciality | Dentist |
Location | 2801 W Ball Rd, Anaheim, California |
Authorized Official Name and Position | Douglas Kim (OWNER) |
Authorized Official Contact | 5622173382 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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First Dental Care 2801 W Ball Rd #10 Anaheim CA 92804-4900 Ph: (714) 527-5656 | First Dental Care 2801 W Ball Rd #10 Anaheim CA 92804-4900 Ph: (714) 527-5656 |
NPI Number | 1952782070 |
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Provider Enumeration Date | 06/15/2015 |
Last Update Date | 06/15/2015 |
Medicare PECOS PAC ID | 2062755093 |
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Medicare Enrollment ID | O20190515001246 |
Identifier | Type | State | Issuer |
---|---|---|---|
1952782070 | NPI | - | NPPES |
1083045173 | Other | CA | NPI TYPE 1 |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
1223G0001X | Dentist - General Practice | 63129 (California) | Primary |
Provider Name | Douglas Kim |
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Provider Type | Practitioner - Oral Surgery |
Provider Identifiers | NPI Number: 1083045173 PECOS PAC ID: 3971846908 Enrollment ID: I20190605003043 |
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