| Premium Dental | |
|
39 Creek Road Suite 220 Irvine CA 92604-7704 | |
| (949) 654-2737 | |
| (949) 654-2740 |
| Full Name | Premium Dental |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 39 Creek Road, Irvine, California |
| Authorized Official Name and Position | Christopher Jordan (OWNER/DENTIST) |
| Authorized Official Contact | 9496542737 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Premium Dental 39 Creek Road Suite 220 Irvine CA 92604-7704 Ph: (949) 654-2737 | Premium Dental 39 Creek Road Suite 220 Irvine CA 92604-7704 Ph: (949) 654-2737 |
| NPI Number | 1104548692 |
|---|---|
| Provider Enumeration Date | 09/13/2022 |
| Last Update Date | 12/29/2022 |
| Certification Date | 12/29/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1104548692 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | () | Primary |
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