| Teen Dental Place | |
|
6361 Pacific Blvd # 100 Huntington Park CA 90255-4101 | |
| (323) 694-7070 | |
| Not Available |
| Full Name | Teen Dental Place |
|---|---|
| Speciality | Dentist |
| Location | 6361 Pacific Blvd # 100, Huntington Park, California |
| Authorized Official Name and Position | Rebecca Misner (OWNER) |
| Authorized Official Contact | 7193232362 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Teen Dental Place 2221 E Bijou St Ste 100 Colorado Springs CO 80909-8009 Ph: (719) 323-2362 | Teen Dental Place 6361 Pacific Blvd # 100 Huntington Park CA 90255-4101 Ph: (323) 694-7070 |
| NPI Number | 1245785070 |
|---|---|
| Provider Enumeration Date | 08/22/2016 |
| Last Update Date | 06/19/2023 |
| Certification Date | 06/19/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1245785070 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | (California) | Primary |
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