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Organization
MAXIMA ERNACIO , DMD, INC.
Active
Organization
MAXIMA ERNACIO , DMD, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MAXIMA J ERNACIO DMD (PRESIDENT)
(213) 483-8756
Entity
Organization
Contact information
Practice address
2105 BEVERLY BLVD, LOS ANGELES, CA 90057-2216
(213) 483-8756
Mailing address
2105 BEVERLY BLVD., SUITE 123, LOS ANGELES, CA 90057-2259
(213) 483-8756
(213) 483-8755
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
44167
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
B44167-01
—
CA
Enumeration date
10/30/2007
Last updated
07/15/2008
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