DR. Koren I T Ikeda, DOCTOR OF DENTAL MED

NPI #1184742744 in Staton, California

Provider Information

NPI Number: 1184742744
Entity Type: Individual
Name: DR. Koren I T Ikeda, DOCTOR OF DENTAL MED
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Dentist - General Practice
Credential: DOCTOR OF DENTAL MED
Enumeration Date: Mar 26, 2007
Last Updated: Jul 18, 2022

Practice Location

Address: 7092 KATELLA AVE.
City: Staton
State: California
ZIP Code: 90680-5179
Phone: (714) 761-0564

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist	122300000X
Dentist - General Practice — General Practice	1223G0001X	Primary

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