| Bennett Jeong, Dds, Inc. | |
|
1057 Via Verde San Dimas CA 91773-4347 | |
| (909) 599-8331 | |
| Not Available |
| Full Name | Bennett Jeong, Dds, Inc. |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 1057 Via Verde, San Dimas, California |
| Authorized Official Name and Position | Bennett Jeong (OWNER) |
| Authorized Official Contact | 9095998331 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Bennett Jeong, Dds, Inc. 1057 Via Verde San Dimas CA 91773-4347 Ph: (909) 599-8331 | Bennett Jeong, Dds, Inc. 1057 Via Verde San Dimas CA 91773-4347 Ph: (909) 599-8331 |
| NPI Number | 1366850778 |
|---|---|
| Provider Enumeration Date | 07/29/2014 |
| Last Update Date | 06/22/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1366850778 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | 63595 (California) | Primary |
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