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Organization
MERCADO DENTAL CORPORATION
Active
Organization
MERCADO DENTAL CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GERARDO MERCADO DDS (OWNER/OFFICER)
(323) 634-9333
Entity
Organization
Contact information
Practice address
5114 VENICE BLVD, LOS ANGELES, CA 90019-5229
(323) 634-9333
Mailing address
5114 VENICE BLVD, LOS ANGELES, CA 90019-5229
(323) 634-9333
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
59598
CA
Other
Enumeration date
12/22/2014
Last updated
01/15/2015
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