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General NPI Number Information
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NPI Number | 1992216717
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Entity Type | Organization
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Legal Business Name | CORNERSTONE DENTISTRY
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Dates
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Enumeration Date | 10/19/2017
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Last Update Date | 10/19/2017
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Provider Practice Location Address
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Address Line | 14120 BEACH BLVD. #212
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City | WESTMINSTER
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State | CA
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Zip | 92683
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Country | US
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Telephone | 714-894-0574
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Fax | 714-894-0345
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Provider Business Mailing Address
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Address Line | 14120 BEACH BLVD. #112
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City | WESTMINISTER
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State | CA
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Zip | 92683
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Country | US
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Telephone | 714-894-0574
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Fax | 714-894-0345
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Authorized Official
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Title or Position | DENTIST
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Name | MR. ERIC HWANG
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Credential | DDS
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Telephone | 714-894-0574
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number | 50273
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License Number State | CA
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