Organization
MAGICLAND DENTAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARIA F HUANOSTO DA (ASSISTANCE)
(310) 329-8241
Entity
Organization
Contact information
Practice address
3820 SEPULVEDA BLVD, TORRANCE, CA 90505-2408
(310) 792-5200
Mailing address
3820 SEPULVEDA BLVD, TORRANCE, CA 90505-2408
(310) 792-5200
Taxonomy
Speciality
Code
Description
License number
State
3140N1450X
Pediatric Skilled Nursing Facility
Primary
4490733
CA
Other
Enumeration date
01/22/2009
Last updated
01/22/2009
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