Provider Demographics
NPI:1306448451
Name:HONEST DENTAL GROUP, INC.
Entity type:Organization
Organization Name:HONEST DENTAL GROUP, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:JOO
Authorized Official - Middle Name:HYEONG
Authorized Official - Last Name:YOO
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:310-570-9731
Mailing Address - Street 1:1135 E ROUTE 66 STE 110
Mailing Address - Street 2:
Mailing Address - City:GLENDORA
Mailing Address - State:CA
Mailing Address - Zip Code:91740-3778
Mailing Address - Country:US
Mailing Address - Phone:626-531-1255
Mailing Address - Fax:
Practice Address - Street 1:1135 E ROUTE 66 STE 110
Practice Address - Street 2:
Practice Address - City:GLENDORA
Practice Address - State:CA
Practice Address - Zip Code:91740-3778
Practice Address - Country:US
Practice Address - Phone:626-531-1255
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-11-13
Last Update Date:2020-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental