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Organization
TOP DENTAL HUNTINGTON PARK INC
Active
Organization
TOP DENTAL HUNTINGTON PARK INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANDREW LEE (PRESIDENT)
(415) 602-2208
Entity
Organization
Contact information
Practice address
6416 SANTA FE AVE, HUNTINGTON PARK, CA 90255
(844) 741-8600
Mailing address
2707 WEST OLYMPIC BLVD, 202, LOS ANGELES, CA 90006
(415) 602-2208
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
—
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
—
—
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1457806499
—
CA
Enumeration date
10/09/2024
Last updated
10/09/2024
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