# A DENTAL GROUP OF WILLIAM E. VICKERMAN DDS

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1356724587
- **Authorized official:** MR. BENSON B. DIMARANAN BSC, RPHT, RDA, OAP (ADMINISTRATIVE DIRECTOR)
- **Authorized official phone:** (562) 202-5741

## Contact information

- **Practice address:** 18000 STUDEBAKER RD STE 365, CERRITOS, CA 90703-2690
- **Practice address phone:** (562) 202-5741
- **Mailing address:** 18000 STUDEBAKER RD STE 365, CERRITOS, CA 90703-2690
- **Mailing address phone:** (562) 202-5741

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | 27704 | CA | Yes |

## Other

- **Enumeration date:** 07/07/2015
- **Last updated:** 07/07/2015