| Fun Dental 4 Kids | |
|
1014 E Manchester Ave Suite I Los Angeles CA 90001 | |
| (323) 562-1301 | |
| Not Available |
| Full Name | Fun Dental 4 Kids |
|---|---|
| Speciality | Dentist |
| Location | 1014 E Manchester Ave, Los Angeles, California |
| Authorized Official Name and Position | John Yoo (OWNER) |
| Authorized Official Contact | 3235621301 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Fun Dental 4 Kids 6383 Atlantic Ave Bell CA 90201-1227 Ph: (323) 562-1301 | Fun Dental 4 Kids 1014 E Manchester Ave Suite I Los Angeles CA 90001 Ph: (323) 562-1301 |
| NPI Number | 1467902031 |
|---|---|
| Provider Enumeration Date | 10/07/2016 |
| Last Update Date | 11/02/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1467902031 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 61918 (California) | Primary |
| 122300000X | Dentist | 61938 (California) | Secondary |
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