Organization
SOL COHEN-SEDGH DENTAL CORPORATION
Active
Other names
MAGICLAND CHILDREN'S DENTISTRY & ORTHODONTICS DENTAL GROUP
Organization subpart
No
Provider details
NPI number
Authorized official
MIGUEL REYES (Q/A CONTRACT AND COMPLIANCE MANAGER)
(310) 409-4225
Entity
Organization
Contact information
Practice address
2254 S EUCLID AVE STE B, ONTARIO, CA 91762-6574
(310) 820-9933
(310) 820-0408
Mailing address
12121 WILSHIRE BLVD STE 1111, LOS ANGELES, CA 90025-1188
(310) 820-9933
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
—
—
1223P0221X
Pediatric Dentistry
Primary
—
—
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
—
—
Other
Enumeration date
08/21/2023
Last updated
08/14/2024
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