| Jesmine Boghawala Dds Inc. | |
|
10929 South St Ste 110b Cerritos CA 90703-5365 | |
| (562) 860-6626 | |
| (562) 860-6628 |
| Full Name | Jesmine Boghawala Dds Inc. |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 10929 South St Ste 110b, Cerritos, California |
| Authorized Official Name and Position | Jesmine Boghawala (DENTIST) |
| Authorized Official Contact | 5628606626 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Jesmine Boghawala Dds Inc. 10929 South St Ste 110b Cerritos CA 90703-5365 Ph: (562) 860-6626 | Jesmine Boghawala Dds Inc. 10929 South St Ste 110b Cerritos CA 90703-5365 Ph: (562) 860-6626 |
| NPI Number | 1033765870 |
|---|---|
| Provider Enumeration Date | 08/16/2019 |
| Last Update Date | 08/16/2019 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1033765870 | NPI | - | NPPES |
| 1235486143 | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | (* (Not Available)) | Primary |
| 302R00000X | Health Maintenance Organization | (* (Not Available)) | Secondary |
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