| Mimi Theerathada Dental Corporation | |
|
9972 Bolsa Ave 102 Westminster CA 92683-6069 | |
| (714) 839-3112 | |
| Not Available |
| Full Name | Mimi Theerathada Dental Corporation |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 9972 Bolsa Ave, Westminster, California |
| Authorized Official Name and Position | Mimi Theerathada (DOCTOR) |
| Authorized Official Contact | 7148393112 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Mimi Theerathada Dental Corporation 9972 Bolsa Ave 102 Westminster CA 92683-6069 Ph: (714) 839-3112 | Mimi Theerathada Dental Corporation 9972 Bolsa Ave 102 Westminster CA 92683-6069 Ph: (714) 839-3112 |
| NPI Number | 1417483371 |
|---|---|
| Provider Enumeration Date | 05/11/2017 |
| Last Update Date | 05/11/2017 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1417483371 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 56371 (California) | Primary |
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