| Ucla Faculty Group Dental Practice | |
|
100 Ucla Medical Plz Ste 350 Los Angeles CA 90095-6999 | |
| (310) 794-5750 | |
| Not Available |
| Full Name | Ucla Faculty Group Dental Practice |
|---|---|
| Speciality | Dentist - Endodontics |
| Location | 100 Ucla Medical Plz Ste 350, Los Angeles, California |
| Authorized Official Name and Position | Rochelle Bache (MANAGER) |
| Authorized Official Contact | 3107945750 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Ucla Faculty Group Dental Practice 100 Ucla Medical Plz Ste 350 Los Angeles CA 90095-6999 Ph: (310) 794-5750 | Ucla Faculty Group Dental Practice 100 Ucla Medical Plz Ste 350 Los Angeles CA 90095-6999 Ph: (310) 794-5750 |
| NPI Number | 1992163786 |
|---|---|
| Provider Enumeration Date | 02/08/2016 |
| Last Update Date | 02/08/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1992163786 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223E0200X | Dentist - Endodontics | 277 (SPECIAL PERMIT) (California) | Primary |
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