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Organization
PRAIRIE FAMILY DENTISTRY
Active
Organization
PRAIRIE FAMILY DENTISTRY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LUDIVINA LUIS PAGATPATAN (OWNER)
(310) 303-3988
Entity
Organization
Contact information
Practice address
3949 ARTESIA BLVD, TORRANCE, CA 90504-3210
(310) 303-3988
(310) 303-3919
Mailing address
3949 ARTESIA BLVD, TORRANCE, CA 90504-3210
(310) 303-3988
(310) 303-3919
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
48162
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
G9282301
—
CA
Enumeration date
04/07/2006
Last updated
08/22/2020
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