| Top West Tower Implant Center Inc | |
|
2707 W Olympic Blvd Ste 202 Los Angeles CA 90006-2859 | |
| (213) 382-4336 | |
| (213) 382-4993 |
| Full Name | Top West Tower Implant Center Inc |
|---|---|
| Speciality | Dentist |
| Location | 2707 W Olympic Blvd Ste 202, Los Angeles, California |
| Authorized Official Name and Position | Andre M Lee (OWNER) |
| Authorized Official Contact | 2133824336 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Top West Tower Implant Center Inc 2707 W Olympic Blvd Ste 202 Los Angeles CA 90006-2859 Ph: (213) 382-4336 | Top West Tower Implant Center Inc 2707 W Olympic Blvd Ste 202 Los Angeles CA 90006-2859 Ph: (213) 382-4336 |
| NPI Number | 1356808711 |
|---|---|
| Provider Enumeration Date | 02/21/2019 |
| Last Update Date | 09/07/2021 |
| Medicare PECOS PAC ID | 8729485511 |
|---|---|
| Medicare Enrollment ID | O20210921002594 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1356808711 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
| 1223S0112X | Dentist - Oral And Maxillofacial Surgery | (* (Not Available)) | Secondary |
| Provider Name | Andre Myongson Lee |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1598908469 PECOS PAC ID: 5092124578 Enrollment ID: I20210513001178 |
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