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Organization
JW JACOB CHAE DMD INC
Active
Organization
JW JACOB CHAE DMD INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JACOB CHAE (CEO/DENTIST)
(213) 705-3811
Entity
Organization
Contact information
Practice address
15862 IMPERIAL HWY, LA MIRADA, CA 90638-2512
(213) 705-3811
Mailing address
15862 IMPERIAL HWY, LA MIRADA, CA 90638-2512
(213) 705-3811
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
261QD0000X
Dental Clinic/Center
—
—
Other
Enumeration date
07/22/2024
Last updated
08/12/2024
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