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Organization
KINGDENTAL
Active
Organization
KINGDENTAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GILBERT L KING DENTIST (CEO)
(323) 464-8677
Entity
Organization
Contact information
Practice address
646 N LARCHMONT BLVD, LOS ANGELES, CA 90004-1308
(323) 464-8677
(323) 463-4692
Mailing address
646 N LARCHMONT BLVD, LOS ANGELES, CA 90004-1308
(323) 464-8677
(323) 463-4692
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
3600141
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
G9398301
DENTI-CAL
CA
01
—
G9398302
DENTI-CAL
CA
Enumeration date
02/14/2007
Last updated
08/22/2020
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