| Full Name | |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 12940 13th St, Chino, California |
| Authorized Official Name and Position | Jihee Chun (OWNER) |
| Authorized Official Contact | 9096483707 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
511 Sunnyside Ave Redlands CA 92373-5629 Ph: (909) 648-3707 | 12940 13th St Chino CA 91710-4359 Ph: (909) 465-0111 |
| NPI Number | 1609594019 |
|---|---|
| Provider Enumeration Date | 08/22/2022 |
| Last Update Date | 08/25/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1609594019 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | (* (Not Available)) | Primary |
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