| Smiles By Alex | |
|
8884 Warner Ave Fountain Valley CA 92708-3200 | |
| (714) 962-2788 | |
| Not Available |
| Full Name | Smiles By Alex |
|---|---|
| Speciality | Dentist |
| Location | 8884 Warner Ave, Fountain Valley, California |
| Authorized Official Name and Position | Luong Nguyen (OWNER) |
| Authorized Official Contact | 7149622788 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Smiles By Alex 8884 Warner Ave Fountain Valley CA 92708-3200 Ph: () - | Smiles By Alex 8884 Warner Ave Fountain Valley CA 92708-3200 Ph: (714) 962-2788 |
| NPI Number | 1164971792 |
|---|---|
| Provider Enumeration Date | 09/23/2016 |
| Last Update Date | 02/02/2017 |
| Medicare PECOS PAC ID | 9638446735 |
|---|---|
| Medicare Enrollment ID | O20170519002253 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1164971792 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223S0112X | Dentist - Oral And Maxillofacial Surgery | 55846 (California) | Primary |
| Provider Name | Luong Nguyen |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1245417765 PECOS PAC ID: 0547537649 Enrollment ID: I20170519002294 |
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