| Greenvalley Oral Care | |
|
3516 Martin Luther King Blvd. Suite 7 Lynwood CA 90262 | |
| (310) 639-7224 | |
| (310) 639-3939 |
| Full Name | Greenvalley Oral Care |
|---|---|
| Speciality | Dentist |
| Location | 3516 Martin Luther King Blvd. Suite 7, Lynwood, California |
| Authorized Official Name and Position | Rafael A Antillon (DENTIST) |
| Authorized Official Contact | 3106397224 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Greenvalley Oral Care 3516 Martin Luther King Blvd. Suite 7 Lynwood CA 90262 Ph: (310) 639-7224 | Greenvalley Oral Care 3516 Martin Luther King Blvd. Suite 7 Lynwood CA 90262 Ph: (310) 639-7224 |
| NPI Number | 1831458637 |
|---|---|
| Provider Enumeration Date | 05/14/2012 |
| Last Update Date | 05/14/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1831458637 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 39747 (California) | Primary |
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