| The Tickled Tooth | |
|
1808 Verdugo Blvd Ste 312 Glendale CA 91208-1456 | |
| (818) 790-6721 | |
| Not Available |
| Full Name | The Tickled Tooth |
|---|---|
| Speciality | Dentist - Pediatric Dentistry |
| Location | 1808 Verdugo Blvd Ste 312, Glendale, California |
| Authorized Official Name and Position | Jean Yoona Kang (PRESIDENT) |
| Authorized Official Contact | 8187906721 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| The Tickled Tooth 1808 Verdugo Blvd Ste 312 Glendale CA 91208-1456 Ph: (818) 790-6721 | The Tickled Tooth 1808 Verdugo Blvd Ste 312 Glendale CA 91208-1456 Ph: (818) 790-6721 |
| NPI Number | 1336971126 |
|---|---|
| Provider Enumeration Date | 08/19/2024 |
| Last Update Date | 08/19/2024 |
| Certification Date | 08/19/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1336971126 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | (NU) | Secondary |
| 1223P0221X | Dentist - Pediatric Dentistry | (NU) | Primary |
| 1223X0400X | Dentist - Orthodontics And Dentofacial Orthopedics | (NU) | Secondary |
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