| Sang G Shin, Dds, Inc. | |
|
12625 Frederick St F-4 Moreno Valley CA 92553-5216 | |
| (951) 697-7750 | |
| (951) 697-7752 |
| Full Name | Sang G Shin, Dds, Inc. |
|---|---|
| Speciality | Dentist |
| Location | 12625 Frederick St, Moreno Valley, California |
| Authorized Official Name and Position | Sang Gyu Shin (CEO) |
| Authorized Official Contact | 9516977750 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Sang G Shin, Dds, Inc. 12625 Frederick St F-4 Moreno Valley CA 92553-5216 Ph: (951) 697-7750 | Sang G Shin, Dds, Inc. 12625 Frederick St F-4 Moreno Valley CA 92553-5216 Ph: (951) 697-7750 |
| NPI Number | 1821425232 |
|---|---|
| Provider Enumeration Date | 09/30/2013 |
| Last Update Date | 09/30/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1821425232 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 59863 (California) | Primary |
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