| K-smile Dentall | |
|
11900 South St Ste 122 Cerritos CA 90703-6800 | |
| (562) 809-6177 | |
| (562) 809-7659 |
| Full Name | K-smile Dentall |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 11900 South St Ste 122, Cerritos, California |
| Authorized Official Name and Position | Ki Baek Lee (DENTIST) |
| Authorized Official Contact | 3238803704 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| K-smile Dentall 11900 South St Ste 122 Cerritos CA 90703-6800 Ph: (562) 809-6177 | K-smile Dentall 11900 South St Ste 122 Cerritos CA 90703-6800 Ph: (562) 809-6177 |
| NPI Number | 1699452821 |
|---|---|
| Provider Enumeration Date | 06/29/2023 |
| Last Update Date | 07/05/2023 |
| Certification Date | 07/05/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1699452821 | NPI | - | NPPES |
| 1508373002 | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | () | Primary |
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