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Organization
SHIV PATEL DENTAL CORP
Active
Organization
SHIV PATEL DENTAL CORP
Active
Other names
Harbor Dental Associates
Organization subpart
No
Provider details
NPI number
Authorized official
MS. JUDY A DOMINGUEZ (OFFICE MANAGER)
(310) 835-3144
Entity
Organization
Contact information
Practice address
25617 DODGE AVE, HARBOR CITY, CA 90710-3101
(310) 835-3144
Mailing address
25617 DODGE AVE, HARBOR CITY, CA 90710-3101
(310) 835-3144
Taxonomy
Speciality
Code
Description
License number
State
302R00000X
Health Maintenance Organization
Primary
CA49973
CA
Other
Enumeration date
02/04/2013
Last updated
02/04/2013
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