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Organization
EUGENE A GONCHAROV DDS INC
Active
Organization
EUGENE A GONCHAROV DDS INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. EUGENE A GONCHAROV DDS (OWNER)
(323) 931-2000
Entity
Organization
Contact information
Practice address
6221 WILSHIRE BLVD, STE 303, LOS ANGELES, CA 90048
(323) 931-2000
(323) 634-9341
Mailing address
6221 WILSHIRE BL, STE 303, LOS ANGELES, CA 90048
(323) 931-2000
(323) 634-9341
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
40823
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
040823
—
CA
Enumeration date
12/15/2006
Last updated
08/22/2020
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