Organization
UCLA GRADUATE PROSTHODONTICS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. ROSA M. GONZALEZ MSO III (OPERATIONS MANAGER)
(310) 206-6926
Entity
Organization
Contact information
Practice address
UCLA GRADUATE PROSTHODONTICS, 10833 LE CONTE AVE. CHS BLDG. ROOM A0-156B, LOS ANGELES, CA 90095-0001
(310) 206-8775
(310) 206-4201
Mailing address
P.O. BOX 84582, UCLA GRADUATE PROSTHODONTICS, LOS ANGELES, CA 90073
(310) 206-8775
(310) 206-4201
Taxonomy
Speciality
Code
Description
License number
State
284300000X
Special Hospital
Primary
D19585
CA
Other
Enumeration date
12/27/2007
Last updated
12/27/2007
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