Individual
DR. MICHELLE IKOMA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.D.S.
Contact information
Practice address
925 W 34TH ST STE 255, LOS ANGELES, CA 90089-0641
(213) 821-1827
Mailing address
5012 W 58TH PL, LOS ANGELES, CA 90056-1637
Taxonomy
Speciality
Code
Description
License number
State
1223P0700X
Prosthodontics
Primary
41093
CA
Other
Enumeration date
05/04/2011
Last updated
05/04/2011
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