| Kyle Nishimura, Dmd, Inc | |
|
1467 N Wanda Rd Ste 105 Villa Park CA 92867-5344 | |
| (310) 525-6996 | |
| Not Available |
| Full Name | Kyle Nishimura, Dmd, Inc |
|---|---|
| Speciality | Dentist |
| Location | 1467 N Wanda Rd Ste 105, Villa Park, California |
| Authorized Official Name and Position | Kyle Nishimura (DENTIST) |
| Authorized Official Contact | 3105256996 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Kyle Nishimura, Dmd, Inc 16610 Taylor Ct Torrance CA 90504-2237 Ph: (310) 525-6996 | Kyle Nishimura, Dmd, Inc 1467 N Wanda Rd Ste 105 Villa Park CA 92867-5344 Ph: (310) 525-6996 |
| NPI Number | 1134666951 |
|---|---|
| Provider Enumeration Date | 01/31/2017 |
| Last Update Date | 01/31/2017 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1134666951 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 62496 (California) | Primary |