| Northeast Dental | |
|
12013 Firestone Blvd Norwalk CA 90650-2908 | |
| (562) 868-8683 | |
| (562) 868-8642 |
| Full Name | Northeast Dental |
|---|---|
| Speciality | Dentist |
| Location | 12013 Firestone Blvd, Norwalk, California |
| Authorized Official Name and Position | Limin Yin (PRESIDENT) |
| Authorized Official Contact | 5628688683 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Northeast Dental 12013 Firestone Blvd Norwalk CA 90650-2908 Ph: (562) 868-8683 | Northeast Dental 12013 Firestone Blvd Norwalk CA 90650-2908 Ph: (562) 868-8683 |
| NPI Number | 1376600924 |
|---|---|
| Provider Enumeration Date | 01/02/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1376600924 | NPI | - | NPPES |
| 93527-01 | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 45343 (California) | Primary |
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