Organization
BAKAEN, KARMEN J, DDS A PROF CORP.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KARMEN BAKAEN (PRESIDENT)
(714) 564-9000
Entity
Organization
Contact information
Practice address
1710 E 17TH ST STE E, SANTA ANA, CA 92705-8622
(714) 564-9000
(714) 564-9024
Mailing address
1710 E 17TH ST STE E, SANTA ANA, CA 92705-8622
(714) 564-9000
(714) 564-9024
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
46360
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
B46360
DENTICAL
CA
Enumeration date
07/25/2007
Last updated
07/25/2007
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