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General NPI Number Information
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NPI Number | 1255252847
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Entity Type | Organization
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Legal Business Name | HUNTINGTON PARK DENTAL IMPLANT CORPORATION
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Dates
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Enumeration Date | 07/21/2026
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Last Update Date | 07/21/2026
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Provider Practice Location Address
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Address Line | 6416 SANTA FE AVE
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City | HUNTINGTON PARK
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State | CA
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Zip | 90255-3808
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Country | US
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Telephone | 323-749-6062
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Fax | 323-749-6519
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Provider Business Mailing Address
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Address Line | 6416 SANTA FE AVE
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City | HUNTINGTON PARK
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State | CA
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Zip | 90255-3808
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Country | US
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Telephone | 213-994-7111
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Fax | 323-749-6519
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Authorized Official
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Title or Position | PRESIDENT
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Name | ALEX LEE
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Credential | DMD
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Telephone | 213-399-4711
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223S0112X
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Taxonomy Name | Oral and Maxillofacial Surgery (Dentist)
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License Number |
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License Number State |
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