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8617 California Ave South Gate CA 90280-3003 | |
(323) 564-5858 | |
Not Available |
Full Name | |
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Speciality | Dentist |
Location | 8617 California Ave, South Gate, California |
Authorized Official Name and Position | Jose Luis Flores (PRESIDENT) |
Authorized Official Contact | 3235645858 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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8617 California Ave South Gate CA 90280-3003 Ph: () - | 8617 California Ave South Gate CA 90280-3003 Ph: (323) 564-5858 |
NPI Number | 1861685497 |
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Provider Enumeration Date | 08/27/2007 |
Last Update Date | 08/27/2007 |
Identifier | Type | State | Issuer |
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1861685497 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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122300000X | Dentist | BF 33577 (California) | Primary |
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