| Mgr Dental Group | |
|
525 S. Azusa Way La Puente CA 91744 | |
| (626) 810-0045 | |
| Not Available |
| Full Name | Mgr Dental Group |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 525 S. Azusa Way, La Puente, California |
| Authorized Official Name and Position | Mayra Sanchez (CEO) |
| Authorized Official Contact | 6262740732 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Mgr Dental Group 525 S. Azusa Way La Puente CA 91744 Ph: (626) 810-0045 | Mgr Dental Group 525 S. Azusa Way La Puente CA 91744 Ph: (626) 810-0045 |
| NPI Number | 1659563120 |
|---|---|
| Provider Enumeration Date | 08/17/2007 |
| Last Update Date | 08/17/2007 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1659563120 | NPI | - | NPPES |
| G92678-01 | Other | CA | DENTICAL PROVIDER |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 46945 (California) | Primary |
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