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Organization
UCLA DENTAL CLINICS
Active
Organization
UCLA DENTAL CLINICS
Active
Other names
UCLA Dental School
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JEFFREY M GOLDSTEIN PHD MBA (DIRECTOR CLINICAL DENTAL CENTER)
(310) 794-5565
Entity
Organization
Contact information
Practice address
10833 LE CONTE AVE, SUITE 10137 CHS, LOS ANGELES, CA 90095-1668
(310) 825-9805
(310) 825-5252
Mailing address
PO BOX 951668, LOS ANGELES, CA 90095-1668
(310) 825-9805
(310) 825-5252
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
G01005
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01005
DELTA DENTAL
CA
01
—
G01005
DENTICAL
CA
Enumeration date
08/31/2006
Last updated
08/22/2020
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