Organization
BERNICE T. KO, D.D.S., INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BERNICE TAN KO (PRESIDENT)
(310) 473-2120
Entity
Organization
Contact information
Practice address
11340 W OLYMPIC BLVD, #360, LOS ANGELES, CA 90064-1608
(310) 473-2120
Mailing address
11340 W OLYMPIC BLVD, #360, LOS ANGELES, CA 90064-1608
(310) 473-2120
Taxonomy
Speciality
Code
Description
License number
State
1223E0200X
Endodontics
Primary
40163
CA
Other
Enumeration date
04/19/2007
Last updated
08/22/2020
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