| Mary Pham Ikeda Dental Corporation | |
|
13047 Artesia Blvd Ste C100 Cerritos CA 90703-1369 | |
| (714) 528-8252 | |
| Not Available |
| Full Name | Mary Pham Ikeda Dental Corporation |
|---|---|
| Speciality | Dentist - Pediatric Dentistry |
| Location | 13047 Artesia Blvd Ste C100, Cerritos, California |
| Authorized Official Name and Position | Mary Regina Pham (CEO PEDIATRIC DENTIST) |
| Authorized Official Contact | 7145288252 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Mary Pham Ikeda Dental Corporation 2750 Harbor Blvd Ste B6 Costa Mesa CA 92626-5121 Ph: (714) 528-8252 | Mary Pham Ikeda Dental Corporation 13047 Artesia Blvd Ste C100 Cerritos CA 90703-1369 Ph: (714) 528-8252 |
| NPI Number | 1518554641 |
|---|---|
| Provider Enumeration Date | 12/22/2020 |
| Last Update Date | 12/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1518554641 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0221X | Dentist - Pediatric Dentistry | (* (Not Available)) | Primary |
| 1223X0400X | Dentist - Orthodontics And Dentofacial Orthopedics | (* (Not Available)) | Secondary |
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