Organization
BYUN LEE AND PATEL A DENTAL CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JUNG WOOK BYUN DDS (SECRETARY)
(949) 878-6680
Entity
Organization
Contact information
Practice address
1313 W 17TH ST STE B, SANTA ANA, CA 92706-3308
(714) 568-1600
Mailing address
1313 W 17TH ST STE B, SANTA ANA, CA 92706-3308
(714) 568-1600
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
48707
CA
1223G0001X
General Practice Dentistry
54717
CA
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
61057
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1104960574
—
CA
05
—
1619227352
—
CA
05
—
1801936968
—
CA
Enumeration date
04/16/2018
Last updated
04/16/2018
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