| Smile Avenue Dental Group | |
|
8543 Rosemead Blvd # D Pico Rivera CA 90660-5427 | |
| (562) 904-0400 | |
| (562) 904-1803 |
| Full Name | Smile Avenue Dental Group |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 8543 Rosemead Blvd, Pico Rivera, California |
| Authorized Official Name and Position | Sophia Rozov (CEO) |
| Authorized Official Contact | 5629040400 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Smile Avenue Dental Group 5640 Etiwanda Ave # 5 Tarzana CA 91356-2700 Ph: (562) 904-0400 | Smile Avenue Dental Group 8543 Rosemead Blvd # D Pico Rivera CA 90660-5427 Ph: (562) 904-0400 |
| NPI Number | 1346365657 |
|---|---|
| Provider Enumeration Date | 03/20/2007 |
| Last Update Date | 01/22/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1346365657 | NPI | - | NPPES |
| 01-45820 | Other | CA | DELTA-DENTAL |
| G93356-01 | Other | CA | DENTI-CAL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 45820 (California) | Primary |
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