| Pico Vista Dental | |
|
2300 W Pico Blvd Suite 204 Los Angeles CA 90006-4021 | |
| (213) 385-6919 | |
| Not Available |
| Full Name | Pico Vista Dental |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 2300 W Pico Blvd, Los Angeles, California |
| Authorized Official Name and Position | Joowon Kim (PRESIDENT) |
| Authorized Official Contact | 9178423225 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Pico Vista Dental 4887 La Palma Ave La Palma CA 90623-2019 Ph: (714) 778-6614 | Pico Vista Dental 2300 W Pico Blvd Suite 204 Los Angeles CA 90006-4021 Ph: (213) 385-6919 |
| NPI Number | 1932533528 |
|---|---|
| Provider Enumeration Date | 08/30/2013 |
| Last Update Date | 08/30/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1932533528 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 54775 (California) | Primary |
| 1223G0001X | Dentist - General Practice | 54886 (California) | Secondary |
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