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Organization

JIRAWAN SRIVIVATANAKUL D.D.S., INC.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. JIRAWAN SRIVIVATANAKUL D.D.S. (DENTIST)
(562) 402-8899
Entity
Organization

Contact information

Practice address
17360 NORWALK BLVD, CERRITOS, CA 90703-2748
(562) 402-8899
Mailing address
17360 NORWALK BLVD, CERRITOS, CA 90703-2748
(562) 402-8899

Taxonomy

Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
48771
CA

Other

Enumeration date
08/13/2007
Last updated
08/13/2007
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