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Organization
JW PROFESSIONAL DENTAL CORPORATION
Active
Organization
JW PROFESSIONAL DENTAL CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GRACE S. HAN D.M.D. (PRESIDENT)
(949) 502-6406
Entity
Organization
Contact information
Practice address
14785 JEFFREY RD. STE 200, IRVINE, CA 92618
(949) 502-6406
(949) 502-6407
Mailing address
PO BOX 50223, IRVINE, CA 92619-0223
(949) 502-6406
(949) 502-6407
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
42322
CA
Other
Enumeration date
08/01/2018
Last updated
08/01/2018
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