Organization
ELIAS & JUN DENTAL CORP
Active
Other names
The Pacific Coast Center for Oral & Facial Surgery
Organization subpart
No
Provider details
NPI number
Authorized official
DR. YOUNG JUN DDS, M.D. (VICE PRESIDENT)
(818) 282-4021
Entity
Organization
Contact information
Practice address
301 S. FAIR OAKS AVE., STE 107, PASADENA, CA 91105
(626) 440-0099
(626) 440-1002
Mailing address
301 S. FAIR OAKS AVE., STE 107, PASADENA, CA 91105
(626) 440-0099
(626) 440-1002
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
—
—
204E00000X
Oral & Maxillofacial Surgery (D.M.D.)
Primary
—
—
208200000X
Plastic Surgery Physician
—
—
2082S0099X
Plastic Surgery Within the Head and Neck (Plastic Surgery) Physician
—
—
2086S0122X
Plastic and Reconstructive Surgery Physician
—
—
Other
Enumeration date
01/12/2018
Last updated
01/12/2018
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