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Organization
UNIVERSITY OF SOUTHERN CALIFORNIA OSTROW SCHOOL OFDENTISTRY MOBILE CLC
Active
Organization
UNIVERSITY OF SOUTHERN CALIFORNIA OSTROW SCHOOL OFDENTISTRY MOBILE CLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. CHARLENE FLOWERS (DIRECTOR OF CLINICAL FINANCE)
(213) 740-7405
Entity
Organization
Contact information
Practice address
925 W 34TH ST # 4202, LOS ANGELES, CA 90089-0058
(213) 740-7405
Mailing address
925 W 34TH ST # 4202, LOS ANGELES, CA 90089-0058
(213) 740-7405
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
D53653
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1447579370
DENTICAL
CA
Enumeration date
11/26/2013
Last updated
11/26/2013
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