| Smile Dental Of Los Angeles | |
|
600 W Manchester Ave Ste 2 Los Angeles CA 90044 | |
| (323) 750-1582 | |
| Not Available |
| Full Name | Smile Dental Of Los Angeles |
|---|---|
| Speciality | Dentist |
| Location | 600 W Manchester Ave Ste 2, Los Angeles, California |
| Authorized Official Name and Position | Michelle Peevy (RDO) |
| Authorized Official Contact | 6614303283 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Smile Dental Of Los Angeles 600 W Manchester Ave Ste 2 Los Angeles CA 90044-5700 Ph: (323) 750-1582 | Smile Dental Of Los Angeles 600 W Manchester Ave Ste 2 Los Angeles CA 90044 Ph: (323) 750-1582 |
| NPI Number | 1386135671 |
|---|---|
| Provider Enumeration Date | 05/23/2018 |
| Last Update Date | 07/03/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1386135671 | NPI | - | NPPES |
| 53724 | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 53724 (California) | Primary |
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