| Michael J. Min, Dds Inc | |
|
1921 E 4th St Ontario CA 91764-2603 | |
| (909) 989-1556 | |
| (909) 989-3132 |
| Full Name | Michael J. Min, Dds Inc |
|---|---|
| Speciality | Dentist |
| Location | 1921 E 4th St, Ontario, California |
| Authorized Official Name and Position | Michael Min (PRESIDENT) |
| Authorized Official Contact | 9099891556 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Michael J. Min, Dds Inc 1921 E 4th St Ontario CA 91764-2603 Ph: () - | Michael J. Min, Dds Inc 1921 E 4th St Ontario CA 91764-2603 Ph: (909) 989-1556 |
| NPI Number | 1245390244 |
|---|---|
| Provider Enumeration Date | 12/11/2006 |
| Last Update Date | 04/02/2021 |
| Medicare PECOS PAC ID | 3173842861 |
|---|---|
| Medicare Enrollment ID | O20150430001450 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1245390244 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 50163 (California) | Primary |
| Provider Name | Michael Min |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1043249436 PECOS PAC ID: 4082933775 Enrollment ID: I20150430001529 |
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