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Organization
ROYAL FAMILY DENTAL INC
Active
Organization
ROYAL FAMILY DENTAL INC
Active
Other names
Royal Family Dental Inc
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ELVIS BAQUERO DDS (DENTIST)
(310) 561-8711
Entity
Organization
Contact information
Practice address
1455 N AVALON BLVD, WILMINGTON, CA 90744-1506
(310) 561-8711
Mailing address
1455 N AVALON BLVD, WILMINGTON, CA 90744-1506
(310) 561-8711
Taxonomy
Speciality
Code
Description
License number
State
305R00000X
Preferred Provider Organization
Primary
49059
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
49059
—
CA
Enumeration date
01/11/2018
Last updated
01/11/2018
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