| San Diego Periodontics & Implant Dentistry | |
|
4060 4th Ave Ste 303 San Diego CA 92103-2120 | |
| (619) 543-0905 | |
| Not Available |
| Full Name | San Diego Periodontics & Implant Dentistry |
|---|---|
| Speciality | Dentist - Periodontics |
| Location | 4060 4th Ave Ste 303, San Diego, California |
| Authorized Official Name and Position | Kennie Kwok (PRESIDENT) |
| Authorized Official Contact | 6195430905 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| San Diego Periodontics & Implant Dentistry 4060 4th Ave Ste 303 San Diego CA 92103-2120 Ph: () - | San Diego Periodontics & Implant Dentistry 4060 4th Ave Ste 303 San Diego CA 92103-2120 Ph: (619) 543-0905 |
| NPI Number | 1073966057 |
|---|---|
| Provider Enumeration Date | 07/14/2016 |
| Last Update Date | 07/14/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1073966057 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0300X | Dentist - Periodontics | 65162 (California) | Primary |
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