| United Dental Northridge Corp | |
|
10149 Reseda Blvd Northridge CA 91324-1454 | |
| (714) 525-6900 | |
| Not Available |
| Full Name | United Dental Northridge Corp |
|---|---|
| Speciality | Dentist |
| Location | 10149 Reseda Blvd, Northridge, California |
| Authorized Official Name and Position | Jeong Hoon Kim (CEO, CFO, & SECRETARY) |
| Authorized Official Contact | 7145256900 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| United Dental Northridge Corp 10149 Reseda Blvd Northridge CA 91324-1454 Ph: () - | United Dental Northridge Corp 10149 Reseda Blvd Northridge CA 91324-1454 Ph: (714) 525-6900 |
| NPI Number | 1891069266 |
|---|---|
| Provider Enumeration Date | 03/02/2012 |
| Last Update Date | 03/02/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1891069266 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | (* (Not Available)) | Primary |
| 126800000X | Dental Assistant | (* (Not Available)) | Secondary |
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