Provider Demographics
NPI:1649737008
Name:TOP DENTAL PASADENA
Entity Type:Organization
Organization Name:TOP DENTAL PASADENA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ANDRE
Authorized Official - Middle Name:M
Authorized Official - Last Name:LEE
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:626-683-9803
Mailing Address - Street 1:950 E COLORADO BLVD STE 201
Mailing Address - Street 2:
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91106-2300
Mailing Address - Country:US
Mailing Address - Phone:626-683-9803
Mailing Address - Fax:626-683-9902
Practice Address - Street 1:950 E COLORADO BLVD STE 201
Practice Address - Street 2:
Practice Address - City:PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91106-2300
Practice Address - Country:US
Practice Address - Phone:626-683-9803
Practice Address - Fax:626-683-9902
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-02-21
Last Update Date:2019-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty