Organization
JWCH INSTITUTE INC
Active
Other names
Bell Gardens Dental Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
ALVARO PROSPERO BALLESTEROS (CHIEF EXECUTIVE OFFICER)
(323) 201-4516
Entity
Organization
Contact information
Practice address
6336 FLORENCE AVE, BELL GARDENS, CA 90201-4732
(323) 201-4516
Mailing address
5650 JILLSON ST, COMMERCE, CA 90040-1482
(323) 201-4516
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
Other
Enumeration date
11/11/2021
Last updated
11/11/2021
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