Individual
BEN UDAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2102 ARTESIA BLVD, TORRANCE, CA 90504-3003
(424) 271-4714
(424) 488-7724
Mailing address
17575 YUKON AVE APT F3, TORRANCE, CA 90504-3441
(857) 206-3875
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
104500
CA
Other
Enumeration date
10/27/2019
Last updated
03/07/2024
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