| San Marino Dental Center | |
|
1901 W 8th St Suite E Los Angeles CA 90057-4900 | |
| (213) 483-8180 | |
| Not Available |
| Full Name | San Marino Dental Center |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 1901 W 8th St, Los Angeles, California |
| Authorized Official Name and Position | Shih-yuan L. Huang (CO-OWNER,CEO) |
| Authorized Official Contact | 2134838180 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| San Marino Dental Center 1901 W 8th St Suite E Los Angeles CA 90057-4900 Ph: (213) 483-8180 | San Marino Dental Center 1901 W 8th St Suite E Los Angeles CA 90057-4900 Ph: (213) 483-8180 |
| NPI Number | 1174682280 |
|---|---|
| Provider Enumeration Date | 12/06/2006 |
| Last Update Date | 07/24/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1174682280 | NPI | - | NPPES |
| D41018 | Other | CA | RENDERING PROVIDER # |
| G92054-01 | Other | CA | DENTI-CAL |
| D45541 | Other | CA | RENDERING PROVIDER # |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 41018 (California) | Primary |
| 1223G0001X | Dentist - General Practice | 45541 (California) | Secondary |
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