| Zacoalco Dental Office | |
|
1420 E Florence Avenue Los Angeles CA 90001 | |
| (323) 277-8110 | |
| (323) 277-8114 |
| Full Name | Zacoalco Dental Office |
|---|---|
| Speciality | Dentist |
| Location | 1420 E Florence Avenue, Los Angeles, California |
| Authorized Official Name and Position | Consuela Mesina Nogoy (PRESIDENT) |
| Authorized Official Contact | 3232778110 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Zacoalco Dental Office 1420 E Florence Avenue Los Angeles CA 90001 Ph: (323) 277-8110 | Zacoalco Dental Office 1420 E Florence Avenue Los Angeles CA 90001 Ph: (323) 277-8110 |
| NPI Number | 1003029737 |
|---|---|
| Provider Enumeration Date | 05/08/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1003029737 | NPI | - | NPPES |
| G9336901 | Other | CA | DENTICAL |
| B4594202 | Other | CA | HEALTHY FAMILIES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 45942 (California) | Primary |
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