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Organization
UNIVERSITY OF SOUTHERN CALIFORNIA
Active
Organization
UNIVERSITY OF SOUTHERN CALIFORNIA
Active
Other names
Herman Ostrow School of Dentistry Mobile Clinic
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
1149 S HILL ST, SUITE H550, LOS ANGELES, CA 90015-2212
(213) 740-7405
Mailing address
1149 S HILL ST, SUITE H550, LOS ANGELES, CA 90015-2212
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
D53653
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
U90595
—
CA
Enumeration date
06/16/2014
Last updated
10/22/2014
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