Organization
EDISON S. HAN, D.D.S., INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. EDISON S HAN D.D.S. (PRESIDENT, DENTIST)
(213) 393-6567
Entity
Organization
Contact information
Practice address
153 W COLLEGE ST, COVINA, CA 91723-2008
(626) 339-9085
Mailing address
153 W COLLEGE ST, COVINA, CA 91723-2008
(626) 339-9085
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
48608
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
G93075-01
DENTI-CAL BILLING ID
CA
Enumeration date
05/31/2007
Last updated
12/28/2009
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