United Dental Fullerton Corp

NPI #1013286590 in Fullerton, California

Provider Information

NPI Number: 1013286590
Entity Type: Organization
Organization Name: United Dental Fullerton Corp
Primary Specialty: Dentist
Enumeration Date: Dec 29, 2011
Last Updated: Dec 29, 2011

Practice Location

Address: 1961 W MALVERN AVE STE G
City: Fullerton
State: California
ZIP Code: 92833-2177
Phone: (714) 525-6900

Authorized Official

Name: JEONG HOON KIM
Title: CEO, CFO, & SECRETARY
Phone: (714) 525-6900

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dental Assistant	126800000X
Dentist	122300000X	Primary

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