# UCLA FACULTY GROUP DENTAL PRACTICE

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1992163786
- **Authorized official:** ROCHELLE BACHE (MANAGER)
- **Authorized official phone:** (310) 794-5750

## Contact information

- **Practice address:** 100 UCLA MEDICAL PLZ STE 350, LOS ANGELES, CA 90095-6999
- **Practice address phone:** (310) 794-5750
- **Mailing address:** 100 UCLA MEDICAL PLZ STE 350, LOS ANGELES, CA 90095-6999
- **Mailing address phone:** (310) 794-5750

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223E0200X | Endodontics | 277 (SPECIAL PERMIT) | CA | Yes |

## Other

- **Enumeration date:** 02/08/2016
- **Last updated:** 02/08/2016