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Organization
DR. PORFIRIO S. MARAVILLA JR. DMD INC
Active
Organization
DR. PORFIRIO S. MARAVILLA JR. DMD INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. PORFIRIO SANTOS MARAVILLA JR. DMD (PRES.)
(213) 388-2466
Entity
Organization
Contact information
Practice address
3540 WILSHIRE BLVD STE 208, LOS ANGELES, CA 90010-2346
(213) 388-2466
(213) 388-9775
Mailing address
3540 WILSHIRE BLVD STE 208, LOS ANGELES, CA 90010-2346
(213) 388-2466
(213) 388-9775
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
32356
CA
Other
Enumeration date
01/18/2007
Last updated
08/22/2020
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