| Ucla Dental School | |
|
10833 Le Conte Ave Suite 10137 Chs Los Angeles CA 90095-1668 | |
| (310) 825-9805 | |
| (310) 825-5252 |
| Full Name | Ucla Dental School |
|---|---|
| Speciality | Dentist |
| Location | 10833 Le Conte Ave, Los Angeles, California |
| Authorized Official Name and Position | Jeffrey M Goldstein (DIRECTOR CLINICAL DENTAL CENTER) |
| Authorized Official Contact | 3107945565 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Ucla Dental School Po Box 951668 Los Angeles CA 90095-1668 Ph: (310) 825-9805 | Ucla Dental School 10833 Le Conte Ave Suite 10137 Chs Los Angeles CA 90095-1668 Ph: (310) 825-9805 |
| NPI Number | 1740392182 |
|---|---|
| Provider Enumeration Date | 08/31/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1740392182 | NPI | - | NPPES |
| G01005 | Other | CA | DENTICAL |
| 01005 | Other | CA | DELTA DENTAL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | G01005 (California) | Primary |
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