| Corporation | |
|
11733 Valley Blvd El Monte CA 91732-3073 | |
| (626) 575-7565 | |
| (626) 575-0240 |
| Full Name | Corporation |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 11733 Valley Blvd, El Monte, California |
| Authorized Official Name and Position | Alfonso Edgar Martinez (PRESIDENT) |
| Authorized Official Contact | 6265757565 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Corporation 11733 Valley Blvd El Monte CA 91732-3073 Ph: (626) 575-7565 | Corporation 11733 Valley Blvd El Monte CA 91732-3073 Ph: (626) 575-7565 |
| NPI Number | 1457572166 |
|---|---|
| Provider Enumeration Date | 05/01/2007 |
| Last Update Date | 12/10/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1457572166 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 25314 (California) | Primary |
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