| Maxima Ernacio , Dmd, Inc. | |
|
2105 Beverly Blvd Los Angeles CA 90057-2216 | |
| (213) 483-8756 | |
| Not Available |
| Full Name | Maxima Ernacio , Dmd, Inc. |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 2105 Beverly Blvd, Los Angeles, California |
| Authorized Official Name and Position | Maxima J Ernacio (PRESIDENT) |
| Authorized Official Contact | 2134838756 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Maxima Ernacio , Dmd, Inc. 2105 Beverly Blvd. Suite 123 Los Angeles CA 90057-2259 Ph: (213) 483-8756 | Maxima Ernacio , Dmd, Inc. 2105 Beverly Blvd Los Angeles CA 90057-2216 Ph: (213) 483-8756 |
| NPI Number | 1801075676 |
|---|---|
| Provider Enumeration Date | 10/30/2007 |
| Last Update Date | 07/15/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1801075676 | NPI | - | NPPES |
| B44167-01 | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 44167 (California) | Primary |
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