Organization
K ITOH DDS INC
Active
Other names
Bleach Dental
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KOUICHI CLIFF ITOH DDS (DENTIST)
(714) 799-9945
Entity
Organization
Contact information
Practice address
11100 WARNER AVE STE 160, FOUNTAIN VALLEY, CA 92708-7510
(714) 799-9945
(657) 218-9699
Mailing address
11100 WARNER AVE STE 160, FOUNTAIN VALLEY, CA 92708-7510
(714) 799-9945
(657) 218-9699
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
09/04/2020
Last updated
10/01/2020
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