Organization
CHERRY DENTAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. AMANDA HANNA DDS (ASSOCIATE DENTIST)
(310) 780-0106
Entity
Organization
Contact information
Practice address
30057 VIA VICTORIA, RANCHO PALOS VERDES, CA 90275-4435
(310) 780-0106
Mailing address
6616 CHERRY AVE, LONG BEACH, CA 90805-1715
(562) 630-5616
Taxonomy
Speciality
Code
Description
License number
State
302R00000X
Health Maintenance Organization
Primary
—
—
305R00000X
Preferred Provider Organization
—
—
Other
Enumeration date
01/23/2015
Last updated
01/23/2015
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