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Organization
SAMUEL R MAEHARA DDS INC
Active
Organization
SAMUEL R MAEHARA DDS INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SAMUEL R MAEHARA DDS (DENTIST)
(562) 865-0013
Entity
Organization
Contact information
Practice address
17700 PIONEER BLVD, ARTESIA, CA 90701-4011
(562) 865-0013
(563) 860-7136
Mailing address
17700 PIONEER BLVD, ARTESIA, CA 90701-4011
(562) 865-0013
(563) 860-7136
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
18371
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
B18371-01
MEDI-CAL
CA
Enumeration date
06/20/2007
Last updated
07/16/2007
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