Healthcare Provider Details

I. General information

NPI: 1982842613
Provider Name (Legal Business Name): HUANG AND LOK DDS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/03/2009
Last Update Date: 02/03/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

710 N BREA BLVD SUITE E
BREA CA
92821-3336
US

IV. Provider business mailing address

710 N BREA BLVD SUITE E
BREA CA
92821-3336
US

V. Phone/Fax

Practice location:
  • Phone: 714-529-8558
  • Fax:
Mailing address:
  • Phone: 714-529-8558
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number51103
License Number StateCA

VIII. Authorized Official

Name: KERRY MAC
Title or Position: SECRETARY
Credential:
Phone: 714-529-8558