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Organization

THE CHILDREN'S DENTAL HEALTH CLINIC

Active
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Organization

THE CHILDREN'S DENTAL HEALTH CLINIC

Active
Parent organization
THE CHILDREN'S DENTAL FOUNDATION
Organization subpart
Yes

Provider details

NPI number
Legal business name
THE CHILDREN'S DENTAL FOUNDATION
Authorized official
DR. JOHN BLAKE D.D.S. (DENTAL DIRECTOR)
(562) 933-3141
Entity
Organization

Contact information

Practice address
10005 FLOWER ST, BELLFLOWER, CA 90706-5412
(562) 804-8100
Mailing address
10005 FLOWER ST, BELLFLOWER, CA 90706-5412
(562) 804-8100

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
D36731
CA
1223G0001X
General Practice Dentistry
Primary
D36731
CA
1223P0221X
Pediatric Dentistry
D36731
CA
126800000X
Dental Assistant
D36731
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
—
G9036004
DENTI-CAL
CA
Enumeration date
10/24/2007
Last updated
10/24/2007
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