Organization
CLINICA DENTAL FAMILIAR SEVILLE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. OSCAR RAMIRO TRIGOSO D.D.S. (OWNER)
(323) 581-1010
Entity
Organization
Contact information
Practice address
6615 SEVILLE AVE, HUNTINGTON PARK, CA 90255-4801
(323) 581-1010
(323) 581-7598
Mailing address
6615 SEVILLE AVE, HUNTINGTON PARK, CA 90255-4801
(323) 581-1010
(323) 581-7598
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
41686
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
G-9245702
DENTICAL
CA
Enumeration date
06/18/2007
Last updated
06/18/2008
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