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3174 E Gage Ave Huntington Park CA 90255-5346 | |
| (323) 581-3011 | |
| (323) 581-3011 |
| Full Name | |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 3174 E Gage Ave, Huntington Park, California |
| Authorized Official Name and Position | Sung Lee (CEO) |
| Authorized Official Contact | 3107871233 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
3174 E Gage Ave Huntington Park CA 90255-5346 Ph: (323) 581-3011 | 3174 E Gage Ave Huntington Park CA 90255-5346 Ph: (323) 581-3011 |
| NPI Number | 1326738287 |
|---|---|
| Provider Enumeration Date | 05/12/2023 |
| Last Update Date | 12/19/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1326738287 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | (* (Not Available)) | Primary |
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