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General NPI Number Information
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NPI Number | 1629873591
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Entity Type | Organization
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Legal Business Name | KHANT DENTAL CORPORATION
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Dates
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Enumeration Date | 02/15/2025
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Last Update Date | 02/15/2025
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Provider Practice Location Address
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Address Line | 10952 REAGAN ST
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City | LOS ALAMITOS
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State | CA
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Zip | 90720-2400
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Country | US
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Telephone | 626-251-6240
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Fax |
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Provider Business Mailing Address
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Address Line | 2601 S 2ND AVE
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City | ARCADIA
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State | CA
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Zip | 91006-5210
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Country | US
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Telephone | 626-251-6240
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. HTET KHANT
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Credential | DDS
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Telephone | 626-251-6240
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number |
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License Number State |
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