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General NPI Number Information
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NPI Number | 1811442072
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Entity Type | Organization
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Legal Business Name | SONY DAO DDS. INC, DBA OC SMILE CO.
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Dates
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Enumeration Date | 08/17/2016
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Last Update Date | 07/22/2024
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Provider Practice Location Address
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Address Line | 8951 KNOTT AVE #L
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City | BUENA PARK
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State | CA
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Zip | 90620
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Country | US
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Telephone | 714-826-4181
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Fax | 714-826-4488
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Provider Business Mailing Address
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Address Line | 8951 KNOTT AVE #L
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City | BUENA PARK
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State | CA
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Zip | 90620
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Country | US
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Telephone | 714-826-4181
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Fax | 714-826-4488
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Authorized Official
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Title or Position | CEO
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Name | DR. SONY DAO
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Credential | DDS
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Telephone | 559-647-0996
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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 | 42991
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License Number State | CA
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