Organization
CHANTISTE BEAL DDS INC
Active
Other names
Chantiste Beal
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CHANTISTE BEAL DMD (OWNER)
(323) 327-1551
Entity
Organization
Contact information
Practice address
8540 S SEPULVEDA BLVD STE 900, LOS ANGELES, CA 90045-3808
(323) 292-2505
(323) 292-2502
Mailing address
12115 2ND AVE, LYNWOOD, CA 90262-4561
(323) 327-1551
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
57857
DENTAL BOARD
CA
Enumeration date
12/05/2022
Last updated
12/05/2022
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