Organization
BO LEE MACDONALD DDS INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BO LEE MACDONALD DDS (OWNER/PRESIDENT)
(310) 479-4459
Entity
Organization
Contact information
Practice address
11340 W OLYMPIC BLVD, SUITE 148, LOS ANGELES, CA 90064-1608
(310) 479-4459
(310) 477-9239
Mailing address
11340 W OLYMPIC BLVD, SUITE 148, LOS ANGELES, CA 90064-1608
(310) 479-4459
(310) 477-9239
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
36955
CA
Other
Enumeration date
05/05/2015
Last updated
05/05/2015
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