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Organization
KOSAL KOM, DDS, INC
Active
Organization
KOSAL KOM, DDS, INC
Active
Other names
Kosal Kom, DDS
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KOSAL KOM DDS (PRESIDENT)
(562) 434-9980
Entity
Organization
Contact information
Practice address
2338 E ANAHEIM ST, SUITE 108, LONG BEACH, CA 90804-5730
(562) 434-9980
Mailing address
2338 E ANAHEIM ST, SUITE 108, LONG BEACH, CA 90804-5730
(562) 434-9980
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
41442
CA
Other
Enumeration date
08/03/2009
Last updated
08/03/2009
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