| Precision Periodontal and Implant Center Dental Corporation | |
|
390 N Pacific Coast Hwy Ste 1070 El Segundo CA 90245-4483 | |
| (310) 708-3938 | |
| Not Available |
| Full Name | Precision Periodontal and Implant Center Dental Corporation |
|---|---|
| Speciality | Dentist - Periodontics |
| Location | 390 N Pacific Coast Hwy Ste 1070, El Segundo, California |
| Authorized Official Name and Position | Dmitriy V Ivanov (OWNER) |
| Authorized Official Contact | 3109268985 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Precision Periodontal and Implant Center Dental Corporation 2406 Mathews Ave Unit A Redondo Beach CA 90278-5503 Ph: (310) 926-8985 | Precision Periodontal and Implant Center Dental Corporation 390 N Pacific Coast Hwy Ste 1070 El Segundo CA 90245-4483 Ph: (310) 708-3938 |
| NPI Number | 1619850088 |
|---|---|
| Provider Enumeration Date | 07/31/2025 |
| Last Update Date | 07/31/2025 |
| Certification Date | 07/30/2025 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1619850088 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0300X | Dentist - Periodontics | (NU) | Primary |
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