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12880 Beach Blvd Suite Aa Stanton CA 90680 | |
| (714) 890-1122 | |
| (714) 896-9512 |
| Full Name | |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 12880 Beach Blvd, Stanton, California |
| Authorized Official Name and Position | Minh Duc Nguyen (PRESIDENT) |
| Authorized Official Contact | 7148901122 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
12880 Beach Blvd Suite Aa Stanton CA 90680 Ph: (714) 890-1122 | 12880 Beach Blvd Suite Aa Stanton CA 90680 Ph: (714) 890-1122 |
| NPI Number | 1689828873 |
|---|---|
| Provider Enumeration Date | 11/14/2008 |
| Last Update Date | 11/14/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1689828873 | NPI | - | NPPES |
| B45505-01 | Other | CA | MEDI - CAL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 45505 (California) | Primary |
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