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Organization
SIMONA D. KISS D.D.S. PROFESSIONAL DENTAL CORPORATION
Active
Organization
SIMONA D. KISS D.D.S. PROFESSIONAL DENTAL CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SIMONA KISS (DENTIST, DIRECTOR)
(714) 730-9656
Entity
Organization
Contact information
Practice address
18102 IRVINE BLVD STE 201, TUSTIN, CA 92780-3424
(714) 730-9656
Mailing address
18102 IRVINE BLVD STE 201, TUSTIN, CA 92780-3424
Taxonomy
Speciality
Code
Description
License number
State
305R00000X
Preferred Provider Organization
Primary
46399
CA
Other
Enumeration date
11/04/2014
Last updated
11/04/2014
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