Organization
PUENTE HILLS DENTAL GROUP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. EVANGELOS ROSSOPOULOS D.D.S. (OWNER)
(626) 854-9530
Entity
Organization
Contact information
Practice address
1850 S AZUSA AVE STE 202, HACIENDA HEIGHTS, CA 91745-6853
(626) 854-9530
Mailing address
1850 S AZUSA AVE STE 202, HACIENDA HEIGHTS, CA 91745-6853
(626) 854-9530
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
31027
CA
1223P0700X
Prosthodontics
36605
CA
Other
Enumeration date
07/27/2007
Last updated
07/27/2007
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