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General NPI Number Information
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NPI Number | 1790875284
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Entity Type | Individual
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Provider Name | KYUNGIEE GINA MUIR D.D.S.
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Gender | Female
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Dates
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Enumeration Date | 10/13/2006
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Last Update Date | 02/26/2013
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Provider Practice Location Address
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Address Line | 10727 WHITE OAK AVE SUITE 211
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City | GRANADA HILLS
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State | CA
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Zip | 91344-4631
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Country | US
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Telephone | 818-363-0300
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Fax | 818-363-7656
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Provider Business Mailing Address
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Address Line | 10727 WHITE OAK AVENUE SUITE 211
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City | GRANADA HILLS
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State | CA
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Zip | 91344
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Country | US
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Telephone | 818-363-0300
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Fax | 818-363-7656
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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 | 122300000X
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Taxonomy Name | Dentist
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License Number | 54881
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License Number State | CA
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