Genesis Dental | |
6040b Atlantic Blvd Maywood CA 90270-3119 | |
(323) 476-7558 | |
(323) 476-7576 |
Full Name | Genesis Dental |
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Speciality | Clinic/center - Dental |
Location | 6040b Atlantic Blvd, Maywood, California |
Authorized Official Name and Position | Rafael T Pou (DENTIST) |
Authorized Official Contact | 9495143500 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Genesis Dental 6040b Atlantic Blvd Maywood CA 90270-3119 Ph: (323) 476-7558 | Genesis Dental 6040b Atlantic Blvd Maywood CA 90270-3119 Ph: (323) 476-7558 |
NPI Number | 1134614134 |
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Provider Enumeration Date | 06/22/2018 |
Last Update Date | 06/22/2018 |
Identifier | Type | State | Issuer |
---|---|---|---|
1134614134 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QD0000X | Clinic/center - Dental | (* (Not Available)) | Primary |
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