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General NPI Number Information
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NPI Number | 1154703890
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Entity Type | Individual
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Provider Name | KYUNG LESLEY HUGH D.D.S.
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Gender | Female
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Dates
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Enumeration Date | 06/18/2015
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Last Update Date | 06/13/2022
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Provider Practice Location Address
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Address Line | 404 S FIGUEROA ST STE 207
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City | LOS ANGELES
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State | CA
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Zip | 90071-1795
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Country | US
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Telephone | 213-700-5573
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Fax |
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Provider Business Mailing Address
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Address Line | 2536 PROSPECT AVE
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City | MONTROSE
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State | CA
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Zip | 91020-1129
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Country | US
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Telephone | 213-700-5573
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Fax | 818-957-4512
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 100744
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License Number State | CA
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