| Rudell Gary S. Jacinto, Dmd, Inc. | |
|
5001 Wilshire Blvd Suite 212 Los Angeles CA 90036-6104 | |
| (323) 931-1385 | |
| Not Available |
| Full Name | Rudell Gary S. Jacinto, Dmd, Inc. |
|---|---|
| Speciality | Dentist |
| Location | 5001 Wilshire Blvd, Los Angeles, California |
| Authorized Official Name and Position | Rudell Gary Santos Jacinto (DENTIST/OWNER) |
| Authorized Official Contact | 3239311385 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Rudell Gary S. Jacinto, Dmd, Inc. 5001 Wilshire Blvd Suite 212 Los Angeles CA 90036-6104 Ph: (323) 931-1385 | Rudell Gary S. Jacinto, Dmd, Inc. 5001 Wilshire Blvd Suite 212 Los Angeles CA 90036-6104 Ph: (323) 931-1385 |
| NPI Number | 1033667282 |
|---|---|
| Provider Enumeration Date | 09/16/2016 |
| Last Update Date | 09/16/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1033667282 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 36383 (California) | Primary |
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