Siderman, Yampolsky Dental Corporation | |
6601 Rugby Ave #400 Huntington Park CA 90255-4040 | |
(323) 585-1515 | |
Not Available |
Full Name | Siderman, Yampolsky Dental Corporation |
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Speciality | Dentist |
Location | 6601 Rugby Ave, Huntington Park, California |
Authorized Official Name and Position | Jerry Siderman (PRESIDENT) |
Authorized Official Contact | 3235851515 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Siderman, Yampolsky Dental Corporation 6601 Rugby Ave #400 Huntington Park CA 90255-4040 Ph: (323) 585-1515 | Siderman, Yampolsky Dental Corporation 6601 Rugby Ave #400 Huntington Park CA 90255-4040 Ph: (323) 585-1515 |
NPI Number | 1396949541 |
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Provider Enumeration Date | 06/12/2007 |
Last Update Date | 08/10/2007 |
Identifier | Type | State | Issuer |
---|---|---|---|
1396949541 | NPI | - | NPPES |
G91803 | Medicaid | CA |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
122300000X | Dentist | (* (Not Available)) | Primary |
1223P0221X | Dentist - Pediatric Dentistry | (* (Not Available)) | Secondary |
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