Organization
SHAW DDS DENTAL CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ROCHELLE R SKINNER D.D.S. (PRESIDENT)
(323) 933-5641
Entity
Organization
Contact information
Practice address
5220 W WASHINGTON BLVD, 103, LOS ANGELES, CA 90016
(323) 933-5641
(323) 939-6620
Mailing address
5220 W WASHINGTON BLVD, 103, LOS ANGELES, CA 90016-1331
(323) 933-5641
(323) 939-6620
Taxonomy
Speciality
Code
Description
License number
State
305R00000X
Preferred Provider Organization
Primary
54813
CA
Other
Enumeration date
04/24/2013
Last updated
10/25/2013
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