| Kingdental | |
|
646 N Larchmont Blvd Los Angeles CA 90004-1308 | |
| (323) 464-8677 | |
| (323) 463-4692 |
| Full Name | Kingdental |
|---|---|
| Speciality | Dentist |
| Location | 646 N Larchmont Blvd, Los Angeles, California |
| Authorized Official Name and Position | Gilbert L King (CEO) |
| Authorized Official Contact | 3234648677 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Kingdental 646 N Larchmont Blvd Los Angeles CA 90004-1308 Ph: (323) 464-8677 | Kingdental 646 N Larchmont Blvd Los Angeles CA 90004-1308 Ph: (323) 464-8677 |
| NPI Number | 1740323401 |
|---|---|
| Provider Enumeration Date | 02/14/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1740323401 | NPI | - | NPPES |
| G9398302 | Other | CA | DENTI-CAL |
| G9398301 | Other | CA | DENTI-CAL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 3600141 (California) | Primary |
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