United Dental Northridge Corp
Dentist in Northridge, CA. Organization (NPI-2).
NPI number1891069266
StatusActive
Last updated in NPPESMar 2, 2012
Details
- NPI
- 1891069266
- Entity type
- Organization (NPI-2)
- Legal business name
- United Dental Northridge Corp
- Organization subpart
- No
- Enumeration date
- Mar 2, 2012
- Last updated
- Mar 2, 2012
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 122300000X | Dentist | – | – | Yes |
| 126800000X | Dental Assistant | – | – |
Practice location
10149 Reseda BlvdNorthridge, CA 91324-1454
Phone 714-525-6900
Mailing address
10149 Reseda BlvdNorthridge, CA 91324-1454
Authorized official
Jeong Hoon Kim
Ceo, Cfo, & Secretary
7145256900
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