NPI 1124423066

Simona D. Kiss D.D.S. Professional Dental Corporation

Organisation Preferred Provider Organization Tustin, CA

Practice location

Address: 18102 Irvine Blvd STE 201, Tustin, CA 92780-3424
Phone: (714) 730-9656

Authorised official

Name: Simona Kiss
Title: Dentist, Director
Phone: (714) 730-9656

Registered specialties

Preferred Provider Organization Primary

Managed Care Organizations Taxonomy 305R00000X Licence 46399 (CA)

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Registry record

NPI: 1124423066
Entity type: Organization
NPI issued: 4 Nov 2014
Record last updated: 4 Nov 2014

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.