Priyawat And Kim Dental Services
Clinic/Center, Oral and Maxillofacial Surgery in Chino Hills, CA. Organization (NPI-2).
NPI number1801461561
StatusActive
Last updated in NPPESAug 22, 2023
Details
- NPI
- 1801461561
- Entity type
- Organization (NPI-2)
- Legal business name
- Priyawat And Kim Dental Services
- Organization subpart
- No
- Enumeration date
- May 25, 2021
- Certification date
- Jun 30, 2021
- Last updated
- Aug 22, 2023
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 261QS0112X | Clinic/Center, Oral and Maxillofacial Surgery | – | – | Yes |
| 1223G0001X | Dentist, General Practice | – | – |
Other names
- Omnia Dental Care (Doing Business As)
Practice location
15911 Pomona Rincon Rd Ste 120Chino Hills, CA 91709-5567
Phone 909-497-9449 · Fax 844-600-4099
Mailing address
15911 Pomona Rincon Rd Ste 120Chino Hills, CA 91709-5567
Phone 909-497-9449
Other practice locations
444 N Harbor Blvd Ste 240
Fullerton, CA 92832-1968
Fullerton, CA 92832-1968
Phone 714-519-3601
Authorized official
Carrick Bannatz
Office Manager
9094979449
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