Premier Dental Suite | |
4635 E Avenue S Palmdale CA 93552-4483 | |
(661) 349-8280 | |
Not Available |
Full Name | Premier Dental Suite |
---|---|
Speciality | Dentist |
Location | 4635 E Avenue S, Palmdale, California |
Authorized Official Name and Position | Song K Kim (PRESIDENT) |
Authorized Official Contact | 6613498280 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Premier Dental Suite 4635 E Avenue S Palmdale CA 93552-4483 Ph: () - | Premier Dental Suite 4635 E Avenue S Palmdale CA 93552-4483 Ph: (661) 349-8280 |
NPI Number | 1003369554 |
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Provider Enumeration Date | 08/02/2016 |
Last Update Date | 11/21/2017 |
Identifier | Type | State | Issuer |
---|---|---|---|
1003369554 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
122300000X | Dentist | (* (Not Available)) | Primary |
261QD0000X | Clinic/center - Dental | (* (Not Available)) | Secondary |
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