| Cerritos Towne Center Dentistry | |
|
17550 Bloomfield Ave Suite C Cerritos CA 90703-8584 | |
| (562) 809-4464 | |
| Not Available |
| Full Name | Cerritos Towne Center Dentistry |
|---|---|
| Speciality | Dentist |
| Location | 17550 Bloomfield Ave, Cerritos, California |
| Authorized Official Name and Position | Winston Muditajaya (PRESIDENT) |
| Authorized Official Contact | 5628094464 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Cerritos Towne Center Dentistry 17550 Bloomfield Ave Suite C Cerritos CA 90703-8584 Ph: (562) 809-4464 | Cerritos Towne Center Dentistry 17550 Bloomfield Ave Suite C Cerritos CA 90703-8584 Ph: (562) 809-4464 |
| NPI Number | 1699895383 |
|---|---|
| Provider Enumeration Date | 03/29/2007 |
| Last Update Date | 06/16/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1699895383 | NPI | - | NPPES |
| G9356501 | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 44515 (California) | Primary |
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