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7758 Knott Ave Buena Park CA 90620-2420 | |
| (714) 522-8723 | |
| (714) 522-4182 |
| Full Name | |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 7758 Knott Ave, Buena Park, California |
| Authorized Official Name and Position | Timothy Jason Brown (CHIEF EXECUTIVE OFFICER) |
| Authorized Official Contact | 2088999631 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
731 S Highland Ave Fullerton CA 92832-2753 Ph: (714) 522-8723 | 7758 Knott Ave Buena Park CA 90620-2420 Ph: (714) 522-8723 |
| NPI Number | 1225397409 |
|---|---|
| Provider Enumeration Date | 05/09/2012 |
| Last Update Date | 06/17/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1225397409 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | (* (Not Available)) | Primary |
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