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39522 10th St W Ste C Palmdale CA 93551-3757 | |
(661) 267-5700 | |
(661) 267-0103 |
Full Name | |
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Speciality | Dentist |
Location | 39522 10th St W Ste C, Palmdale, California |
Authorized Official Name and Position | Gloria Won (CFO) |
Authorized Official Contact | 6612675700 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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39522 10th St W Ste C Palmdale CA 93551-3757 Ph: (661) 267-5700 | 39522 10th St W Ste C Palmdale CA 93551-3757 Ph: (661) 267-5700 |
NPI Number | 1700372679 |
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Provider Enumeration Date | 07/03/2018 |
Last Update Date | 05/16/2024 |
Identifier | Type | State | Issuer |
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1700372679 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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122300000X | Dentist | 44125 (California) | Primary |