Organization
SIMONA D. KISS D.D.S. PROFESSIONAL DENTAL CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SIMONA KISS (DENTIST, DIRECTOR)
(714) 730-9656
Entity
Organization
Contact information
Practice address
18102 IRVINE BLVD STE 201, TUSTIN, CA 92780-3424
(714) 730-9656
Mailing address
18102 IRVINE BLVD STE 201, TUSTIN, CA 92780-3424
Taxonomy
Speciality
Code
Description
License number
State
305R00000X
Preferred Provider Organization
Primary
46399
CA
Other
Enumeration date
11/04/2014
Last updated
11/04/2014
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