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General NPI Number Information
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NPI Number | 1851781868
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Entity Type | Organization
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Legal Business Name | MIN SWE D.D.S., INC.
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Dates
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Enumeration Date | 01/28/2015
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Last Update Date | 01/28/2015
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Provider Practice Location Address
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Address Line | 15278 MAIN ST B
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City | HESPERIA
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State | CA
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Zip | 92345-3300
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Country | US
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Telephone | 760-244-1111
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Fax | 760-244-1818
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Provider Business Mailing Address
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Address Line | 15278 MAIN ST B
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City | HESPERIA
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State | CA
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Zip | 92345-3300
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Country | US
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Telephone | 760-244-1111
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Fax | 760-244-1818
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Authorized Official
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Title or Position | VICE PRESIDENT
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Name | MS. ELENA ARMENDAREZ
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Credential |
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Telephone | 760-912-6274
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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 | 50536
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License Number State | CA
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