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Organization
WALTER JEFFERSON, D.D.S., INC.
Active
Organization
WALTER JEFFERSON, D.D.S., INC.
Active
Other names
The Dental Office of Carson
Organization subpart
No
Provider details
NPI number
Authorized official
DR. WALTER JEFFERSON DDS (OWNER)
(310) 469-9355
Entity
Organization
Contact information
Practice address
612 E CARSON ST, SUITE 101, CARSON, CA 90745
(310) 469-9355
(310) 414-0800
Mailing address
17000 RED HILL AVENUE, IRVINE, CA 92614
(714) 845-8890
(949) 474-1495
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
—
Other
Enumeration date
12/19/2016
Last updated
12/22/2016
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