| Leimert Dental Practice Of Utibe Effiom Dds, Inc. | |
|
3991 S Western Ave #7 Los Angeles CA 90062-1193 | |
| (310) 397-1064 | |
| Not Available |
| Full Name | Leimert Dental Practice Of Utibe Effiom Dds, Inc. |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 3991 S Western Ave, Los Angeles, California |
| Authorized Official Name and Position | Utibe Effiom (PRESIDENT) |
| Authorized Official Contact | 3103971064 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Leimert Dental Practice Of Utibe Effiom Dds, Inc. Po Box 341935 Los Angeles CA 90034-8983 Ph: (310) 397-1064 | Leimert Dental Practice Of Utibe Effiom Dds, Inc. 3991 S Western Ave #7 Los Angeles CA 90062-1193 Ph: (310) 397-1064 |
| NPI Number | 1861938474 |
|---|---|
| Provider Enumeration Date | 01/06/2017 |
| Last Update Date | 01/06/2017 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1861938474 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 54249 (California) | Primary |
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