| Pro Dentista Dental Group | |
|
2634 Clarendon Ave Huntington Park CA 90255-4120 | |
| (323) 585-2777 | |
| Not Available |
| Full Name | Pro Dentista Dental Group |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 2634 Clarendon Ave, Huntington Park, California |
| Authorized Official Name and Position | Teresa Hayrapetian (CONSULTANT) |
| Authorized Official Contact | 8182626114 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Pro Dentista Dental Group 2634 Clarendon Ave Huntington Park CA 90255-4120 Ph: () - | Pro Dentista Dental Group 2634 Clarendon Ave Huntington Park CA 90255-4120 Ph: (323) 585-2777 |
| NPI Number | 1487976759 |
|---|---|
| Provider Enumeration Date | 02/26/2010 |
| Last Update Date | 02/26/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1487976759 | NPI | - | NPPES |
| 1881924298 | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
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