Individual
DR. STANLEY MITSUO MIYAWAKI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.M.D., M.S.
Contact information
Practice address
11980 SAN VICENTE BLVD., SUITE 602, LOS ANGELES, CA 90049-6604
(310) 826-6694
(310) 826-3602
Mailing address
11980 SAN VICENTE BLVD., SUITE 602, LOS ANGELES, CA 90049-6604
(310) 826-6694
(310) 826-3602
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
30979
CA
Other
Enumeration date
02/27/2007
Last updated
07/08/2007
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