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General NPI Number Information
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NPI Number | 1336668110
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Entity Type | Organization
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Legal Business Name | HOSS KM DENTAL GROUP, A PROFESSIONAL GROUP
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Dates
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Enumeration Date | 09/13/2017
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Last Update Date | 03/18/2019
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Provider Practice Location Address
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Address Line | 9737 AERO DR
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City | SAN DIEGO
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State | CA
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Zip | 92123-1859
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Country | US
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Telephone | 619-636-2665
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Fax | 619-636-2665
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Provider Business Mailing Address
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Address Line | 9737 AERO DR
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City | SAN DIEGO
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State | CA
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Zip | 92123-1859
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Country | US
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Telephone | 619-636-2665
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Fax |
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Authorized Official
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Title or Position | DOCTOR/PRESIDENT
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Name | DR. KAMI HOSS
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Credential | DMD
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Telephone | 619-961-9867
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number | 41016
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License Number State | CA
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