is a General Practice in Hawthorne, California. practices all healthcare services and medical treatments related to General Practice. The NPI Number for is 1912116971. The last update date is .
's current location address is 12703 Prairie Ave, Hawthorne, California. You can contact this provider via phone number 3106762442. The mailing address for is 12703 Prairie Ave, Hawthorne, California. To know further, please read the information below!
Provider Profile Detail
| Provider Name | |
|---|---|
| Address | 12703 Prairie Ave, Hawthorne, California |
| Phone Number | 3106762442 |
| Fax Number | |
| Sole Proprietor | -- |
| Credentials | -- |
NPI Number Detail
| NPI Number | 1912116971 |
|---|---|
| Provider Enumeration Date | |
| Last Updated Date |
Provider Mailing Address Detail
| Address | 12703 Prairie Ave |
|---|---|
| City | Hawthorne |
| State | California (CA) |
| Post Code | 902504612 |
| Phone Number | 3106762442 |
| Fax Number |
Provider's Primary Taxonomy Detail
| Speciality | General Practice |
|---|---|
| Taxonomy | 1223G0001X |
| Licence No | D44176 |
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Definition: A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs. |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| D44176 | CA | MEDICAL |
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