| Premier Dental Suite | |
|
4635 E Avenue S # C103 Palmdale CA 93552-4483 | |
| (661) 349-8280 | |
| (661) 349-4462 |
| 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 |
|---|---|
| Premier Dental Suite 4635 E Avenue S # C103 Palmdale CA 93552-4483 Ph: (661) 349-8280 | Premier Dental Suite 4635 E Avenue S # C103 Palmdale CA 93552-4483 Ph: (661) 349-8280 |
| NPI Number | 1386192821 |
|---|---|
| Provider Enumeration Date | 09/13/2016 |
| Last Update Date | 11/21/2017 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1386192821 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 58863 (California) | Primary |
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