| Mercado Dental Corporation | |
|
5114 Venice Blvd Los Angeles CA 90019-5229 | |
| (323) 634-9333 | |
| Not Available |
| Full Name | Mercado Dental Corporation |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 5114 Venice Blvd, Los Angeles, California |
| Authorized Official Name and Position | Gerardo Mercado (OWNER/OFFICER) |
| Authorized Official Contact | 3236349333 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Mercado Dental Corporation 5114 Venice Blvd Los Angeles CA 90019-5229 Ph: (323) 634-9333 | Mercado Dental Corporation 5114 Venice Blvd Los Angeles CA 90019-5229 Ph: (323) 634-9333 |
| NPI Number | 1164810305 |
|---|---|
| Provider Enumeration Date | 12/22/2014 |
| Last Update Date | 01/15/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1164810305 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 59598 (California) | Primary |
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