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411 S Long Beach Blvd Compton CA 90221-3427 | |
| (310) 537-2217 | |
| (310) 537-8062 |
| Full Name | |
|---|---|
| Speciality | Dentist - Pediatric Dentistry |
| Location | 411 S Long Beach Blvd, Compton, California |
| Authorized Official Name and Position | Alphonso Faison (CORPORATION SECRETARY) |
| Authorized Official Contact | 3105372217 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
411 S Long Beach Blvd Compton CA 90221-3427 Ph: (310) 537-2217 | 411 S Long Beach Blvd Compton CA 90221-3427 Ph: (310) 537-2217 |
| NPI Number | 1154314060 |
|---|---|
| Provider Enumeration Date | 08/25/2005 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1154314060 | NPI | - | NPPES |
| B2525202 | Other | CA | DENTI-CAL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0221X | Dentist - Pediatric Dentistry | 37330 (California) | Secondary |
| 1223P0221X | Dentist - Pediatric Dentistry | 25252 (California) | Primary |
Korouri Sage Bina Professional Dental Inc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 609 S Long Beach Blvd, Compton, CA 90221 Phone: 310-876-2534 | |
Linda C. Onyeador, D.d.s., Inc. Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 555 W Compton Blvd, Suite #103, Compton, CA 90220 Phone: 310-762-9292 Fax: 310-762-6680 |