Organization
MAXWELL DENTAL CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. FRANDSEN DORSEY MAXWELL D.D.S. (CEO,PRESIDENT,DENTIST)
(310) 216-0971
Entity
Organization
Contact information
Practice address
6828 LA TIJERA BLVD, LOS ANGELES, CA 90045-1905
(310) 216-0971
(310) 216-1530
Mailing address
6828 LA TIJERA BLVD, LOS ANGELES, CA 90045-1905
(310) 216-0971
(310) 216-1530
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
35944
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
662491
UNITED CONCORDIA
CA
01
—
B03594401
DENTI-CAL
CA
Enumeration date
04/26/2007
Last updated
09/30/2008
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