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Organization
PORTABLE DENTAL DIAGNOSTIC SERVICES
Active
Organization
PORTABLE DENTAL DIAGNOSTIC SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHELLE HYUNAECHANG MEADOR DMD (COE)
(415) 279-5978
Entity
Organization
Contact information
Practice address
10924 DAINES DR, TEMPLE CITY, CA 91780-2920
(415) 279-5978
Mailing address
10924 DAINES DR, TEMPLE CITY, CA 91780-2920
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
63128
CA
Other
Enumeration date
05/07/2014
Last updated
05/07/2014
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