| |
10530 Atlantic Ave South Gate CA 90280-7024 | |
(323) 569-5000 | |
(323) 569-4000 |
Full Name | |
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Speciality | Clinic/center - Dental |
Location | 10530 Atlantic Ave, South Gate, California |
Authorized Official Name and Position | Ardy Hakhamian (OWNER/DENTIST) |
Authorized Official Contact | 3235695000 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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10530 Atlantic Ave South Gate CA 90280-7024 Ph: (323) 569-5000 | 10530 Atlantic Ave South Gate CA 90280-7024 Ph: (323) 569-5000 |
NPI Number | 1568964856 |
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Provider Enumeration Date | 03/02/2018 |
Last Update Date | 03/02/2018 |
Identifier | Type | State | Issuer |
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1568964856 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QD0000X | Clinic/center - Dental | 63487 (California) | Primary |
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