Organization
KANOKNUCH SHIFLETT DENTAL CORP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KANOKNUCH SHIFLETT DDS (CEO)
(626) 991-3544
Entity
Organization
Contact information
Practice address
906 S SUNSET AVE STE 105, WEST COVINA, CA 91790-3400
(626) 480-1543
(626) 480-0622
Mailing address
906 S SUNSET AVE STE 105, WEST COVINA, CA 91790-3400
(626) 480-1543
(626) 480-0622
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
40303
CA
Other
Enumeration date
08/20/2018
Last updated
06/11/2019
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