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General NPI Number Information
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NPI Number | 1922634591
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Entity Type | Organization
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Legal Business Name | ASY DENTAL ASSOCIATES
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Dates
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Enumeration Date | 03/16/2020
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Last Update Date | 06/14/2021
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Provider Practice Location Address
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Address Line | 11033 ROSECRANS AVE #D
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City | NORWALK
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State | CA
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Zip | 90650-3663
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Country | US
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Telephone | 562-929-3083
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Fax | 844-598-1171
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Provider Business Mailing Address
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Address Line | 1704 W 169TH PLACE
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City | GARDENA
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State | CA
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Zip | 90247-5306
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Country | US
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Telephone | 562-929-3083
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Fax | 844-598-1171
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Authorized Official
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Title or Position | DENTIST/OWNER
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Name | DR. ANDY S YOON
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Credential | D.M.D
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Telephone | 562-929-3083
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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 |
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License Number State |
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