Organization
DENTALVILLE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. EVELYN MCKAY (OFFICE MANAGER)
(323) 560-1508
Entity
Organization
Contact information
Practice address
5021 FLORENCE AVENUE, BELL, CA 90201
(323) 560-1508
(323) 560-2085
Mailing address
5021 FLORENCE AVENUE, BELL, CA 90201
(323) 560-1508
(323) 560-2085
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
B26405-04
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
B26405-04
DENTICAL
CA
Enumeration date
06/29/2007
Last updated
08/22/2020
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