| Long Beach Dental | |
|
308 Orange Ave Long Beach CA 90802-3536 | |
| (562) 436-4214 | |
| Not Available |
| Full Name | Long Beach Dental |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 308 Orange Ave, Long Beach, California |
| Authorized Official Name and Position | Atef R. Rezkalla (OWNER) |
| Authorized Official Contact | 5624364214 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Long Beach Dental 308 Orange Ave Long Beach CA 90802-3536 Ph: (562) 436-4214 | Long Beach Dental 308 Orange Ave Long Beach CA 90802-3536 Ph: (562) 436-4214 |
| NPI Number | 1689888711 |
|---|---|
| Provider Enumeration Date | 05/09/2007 |
| Last Update Date | 02/06/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1689888711 | NPI | - | NPPES |
| G89823 | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 48004 (California) | Primary |
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