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6438 Rita Ave Huntington Park CA 90255 | |
| (323) 277-4044 | |
| (323) 277-4047 |
| Full Name | |
|---|---|
| Speciality | Dentist |
| Location | 6438 Rita Ave, Huntington Park, California |
| Authorized Official Name and Position | Raymond M. Tash (PRESIDENT/OWNER) |
| Authorized Official Contact | 3232774044 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
6438 Rita Ave Huntington Park CA 90255 Ph: (323) 277-4044 | 6438 Rita Ave Huntington Park CA 90255 Ph: (323) 277-4044 |
| NPI Number | 1982181947 |
|---|---|
| Provider Enumeration Date | 07/23/2018 |
| Last Update Date | 07/23/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1982181947 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 43564 (California) | Primary |
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