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General NPI Number Information
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NPI Number | 1891912168
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Entity Type | Organization
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Legal Business Name | FRIENDLY ENDODONTICS INC
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Dates
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Enumeration Date | 04/19/2007
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Last Update Date | 12/09/2020
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Provider Practice Location Address
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Address Line | 933 S SUNSET AVE STE 303
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City | WEST COVINA
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State | CA
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Zip | 91790-3410
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Country | US
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Telephone | 626-918-8700
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Fax |
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Provider Business Mailing Address
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Address Line | 933 S SUNSET AVE STE 303
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City | WEST COVINA
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State | CA
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Zip | 91790-3410
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Country | US
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Telephone | 626-814-8040
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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. KWOR CHIEH LOO
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Credential | D.D.S.
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Telephone | 626-475-7424
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223E0200X
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Taxonomy Name | Endodontics
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License Number | 45489
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License Number State | CA
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