| Manuel G. Domantaydds, Inc | |
|
6200 Wilshire Blvd., Ste. 909 Los Angeles CA 90048-5801 | |
| (323) 935-2111 | |
| Not Available |
| Full Name | Manuel G. Domantaydds, Inc |
|---|---|
| Speciality | Dentist |
| Location | 6200 Wilshire Blvd., Ste. 909, Los Angeles, California |
| Authorized Official Name and Position | Manuel G Domantay (PRESIDENT) |
| Authorized Official Contact | 3239352111 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Manuel G. Domantaydds, Inc 6200 Wilshire Blvd Ste 909 Los Angeles CA 90048-5810 Ph: (323) 935-2111 | Manuel G. Domantaydds, Inc 6200 Wilshire Blvd., Ste. 909 Los Angeles CA 90048-5801 Ph: (323) 935-2111 |
| NPI Number | 1417161050 |
|---|---|
| Provider Enumeration Date | 05/10/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1417161050 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | (* (Not Available)) | Primary |
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