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Organization

SANDRA CALLEROS, A PROFESSIONAL CORP

Active
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Organization

SANDRA CALLEROS, A PROFESSIONAL CORP

Active
Other names
Calleros Dental
Organization subpart
No

Provider details

NPI number
Authorized official
DR. SANDRA CALLEROS DDS (OWNER)
(310) 414-9564
Entity
Organization

Contact information

Practice address
131 W GRAND AVE, SUITE B, EL SEGUNDO, CA 90245-3738
(310) 414-9564
(310) 414-9773
Mailing address
131 W GRAND AVE, SUITE B, EL SEGUNDO, CA 90245-3738
(310) 414-9564
(310) 414-9773

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
35478
CA
1223G0001X
General Practice Dentistry
62902
CA

Other

Enumeration date
03/09/2015
Last updated
03/09/2015
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