Healthcare Provider Details

I. General information

NPI: 1811097868
Provider Name (Legal Business Name): EMELINE G SEE DMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/22/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12840 RIVERSIDE DR #308
STUDIO CITY CA
91607
US

IV. Provider business mailing address

12840 RIVERSIDE DR #308
STUDIO CITY CA
91607
US

V. Phone/Fax

Practice location:
  • Phone: 818-985-8688
  • Fax: 818-985-8687
Mailing address:
  • Phone: 818-985-8688
  • Fax: 818-985-8687

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number40013
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: