| Star Dental Practice | |
|
2096 W. La Habra Blvd La Habra CA 90631-5007 | |
| (562) 905-1828 | |
| Not Available |
| Full Name | Star Dental Practice |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 2096 W. La Habra Blvd, La Habra, California |
| Authorized Official Name and Position | Jurie Du Fang (CORPORATE SECRETARY,DENTIST) |
| Authorized Official Contact | 5629051828 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Star Dental Practice 2096 W. La Habra Blvd La Habra CA 90631-5007 Ph: (562) 905-1828 | Star Dental Practice 2096 W. La Habra Blvd La Habra CA 90631-5007 Ph: (562) 905-1828 |
| NPI Number | 1932316411 |
|---|---|
| Provider Enumeration Date | 05/16/2007 |
| Last Update Date | 09/12/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1932316411 | NPI | - | NPPES |
| G91417-01 | Other | CA | DENTI-CAL BILLING PROVIDR |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 41074 (California) | Primary |
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