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Organization
MA DENTAL CORPORATION
Active
Organization
MA DENTAL CORPORATION
Active
Other names
Ma Family Dental
Organization subpart
No
Provider details
NPI number
Authorized official
JUDY MA D.D.S. (OWNER)
(310) 373-6565
Entity
Organization
Contact information
Practice address
3655 LOMITA BLVD, SUITE 109, TORRANCE, CA 90505-3931
(310) 373-6565
(310) 373-6553
Mailing address
3655 LOMITA BLVD, SUITE 109, TORRANCE, CA 90505-3931
(310) 373-6565
(310) 373-6553
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
44421
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
962057
UNITED CONCORDIA
—
Enumeration date
02/09/2007
Last updated
08/22/2020
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