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Organization
GREENLEAF DENTAL SPA
Active
Organization
GREENLEAF DENTAL SPA
Active
Other names
Greenleaf Dental Spa
Organization subpart
No
Provider details
NPI number
Authorized official
MS. CECILLIA TU (MANAGER)
(626) 695-7448
Entity
Organization
Contact information
Practice address
1758 SIERRA LEONE AVE STE C, ROWLAND HEIGHTS, CA 91748-5837
(626) 695-7448
(626) 695-7448
Mailing address
1758 SIERRA LEONE AVE STE C, ROWLAND HEIGHTS, CA 91748-5837
(626) 695-7448
(626) 964-6681
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
56784
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
56784
DDS
CA
Enumeration date
01/10/2018
Last updated
04/22/2019
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