| NPI | 1003369554 |
|---|---|
| Doing Business As | PREMIER DENTAL SUITE |
| Entity Type | Organization |
| Authorized Contact | SONG K KIM President 661-349-8280 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist |
| Additional Taxonomies | 261QD0000X Clinic/Center, Dental |
| Enumeration Date | 2016-08-02 |
| Last Update Date | 2017-11-21 |