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Organization
MUDITAJAYA DENTAL CORPORATION
Active
Organization
MUDITAJAYA DENTAL CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DANNY MUDITAJAYA DDS (CEO)
(562) 949-0177
Entity
Organization
Contact information
Practice address
9123 SLAUSON AVE, PICO RIVERA, CA 90660-4522
(562) 949-0177
(562) 949-4776
Mailing address
9123 SLAUSON AVE, PICO RIVERA, CA 90660-4522
(562) 949-0177
(562) 949-4776
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
30419
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
G9166001
—
CA
Enumeration date
10/17/2006
Last updated
03/09/2010
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