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Organization
SANG PAIK DDS, INC
Active
Organization
SANG PAIK DDS, INC
Active
Other names
San Jacinto Dental Center
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JASON LEE DDS (CFO)
(951) 654-8005
Entity
Organization
Contact information
Practice address
166 E MAIN ST, SUITE 6, SAN JACINTO, CA 92583-4200
(951) 654-8005
(951) 654-3680
Mailing address
166 E MAIN ST, SUITE 6, SAN JACINTO, CA 92583-4200
(951) 654-8005
(951) 654-3680
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
41861
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
B41861-02
—
CA
Enumeration date
05/08/2007
Last updated
08/22/2007
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