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26572 Bouquet Canyon Rd Saugus CA 91350-2353 | |
| (661) 297-8383 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 26572 Bouquet Canyon Rd, Saugus, California |
| Authorized Official Name and Position | Alexi Kossi (PRESIDENT) |
| Authorized Official Contact | 6617029595 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
26572 Bouquet Canyon Rd Saugus CA 91350-2353 Ph: (661) 297-8383 | 26572 Bouquet Canyon Rd Saugus CA 91350-2353 Ph: (661) 297-8383 |
| NPI Number | 1730384033 |
|---|---|
| Provider Enumeration Date | 06/18/2007 |
| Last Update Date | 08/05/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1730384033 | NPI | - | NPPES |
| B42659-02 | Other | CA | DENTI-CAL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 42659 (California) | Primary |
Brandon Thai Dds, Inc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 28100 Bouquet Canyon Rd, 200, Saugus, CA 91350 Phone: 661-263-6923 | |