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180 E 4th St Ste A Perris CA 92570-2114 | |
| (951) 657-3102 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 180 E 4th St Ste A, Perris, California |
| Authorized Official Name and Position | Jihee Chun (PRESIDENT) |
| Authorized Official Contact | 9096483707 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
210 W C St Ontario CA 91762-3404 Ph: () - | 180 E 4th St Ste A Perris CA 92570-2114 Ph: (951) 657-3102 |
| NPI Number | 1356931117 |
|---|---|
| Provider Enumeration Date | 01/25/2021 |
| Last Update Date | 08/25/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1356931117 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | (* (Not Available)) | Primary |
Tejas Modi Dds Inc Dental Clinic Medicare: Medicare Enrolled Practice Location: 75 W Nuevo Rd Ste A&b, Perris, CA 92571 Phone: 951-657-1203 | |
Chung Kim Dds, Inc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 180 E 4th St, Suite A, Perris, CA 92570 Phone: 951-657-3102 Fax: 951-657-7783 | |
Soonhyuk Chang Dds Inc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 126 Avocado Ave Ste 202, Perris, CA 92571 Phone: 951-940-0202 Fax: 951-943-4844 | |