MEDICARE: EMELINE G SEE DMD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	122300000X	Dentist	40013	CA

General Provider Information

NPI Number	:	1811097868
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	EMELINE G SEE DMD

Provider Business Mailing Address
First Line	:	12840 RIVERSIDE DR #308
Second Line	:
City	:	STUDIO CITY
State	:	CA
Zip	:	91607
Country	:	US
Telephone Number	:	818-985-8688
Fax Number	:	818-985-8687

Provider Business Practice Location Address
First Line	:	12840 RIVERSIDE DR #308
Second Line	:
City	:	STUDIO CITY
State	:	CA
Zip	:	91607
Country	:	US
Telephone Number	:	818-985-8688
Fax Number	:	818-985-8687

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/22/2006
Last Update Date	:	07/08/2007

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Directions to “ EMELINE G SEE DMD” Practice Location

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