| Town Dental Group | |
|
3352 W Olympic Blvd Los Angeles CA 90019-2320 | |
| (323) 732-5500 | |
| (323) 732-6500 |
| Full Name | Town Dental Group |
|---|---|
| Speciality | Dentist |
| Location | 3352 W Olympic Blvd, Los Angeles, California |
| Authorized Official Name and Position | Justin D Hwang (OWNER) |
| Authorized Official Contact | 3237325500 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Town Dental Group 3352 W Olympic Blvd Los Angeles CA 90019-2320 Ph: (323) 732-5500 | Town Dental Group 3352 W Olympic Blvd Los Angeles CA 90019-2320 Ph: (323) 732-5500 |
| NPI Number | 1215134226 |
|---|---|
| Provider Enumeration Date | 07/02/2007 |
| Last Update Date | 01/28/2016 |
| Medicare PECOS PAC ID | 0345543088 |
|---|---|
| Medicare Enrollment ID | O20160129000995 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1215134226 | NPI | - | NPPES |
| B35273-02 | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 35273 (California) | Primary |
| Provider Name | Justin D Hwang |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1568599165 PECOS PAC ID: 9133422876 Enrollment ID: I20160215001470 |
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