Organization
E. N. ST. GEORGE, DDS, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. EDWARD NICHOLAS ST. GEORGE DDS (PRESIDENT)
(562) 927-2602
Entity
Organization
Contact information
Practice address
10249 PARAMOUNT BLVD, DOWNEY, CA 90241-2362
(562) 927-2602
(562) 928-9232
Mailing address
10249 PARAMOUNT BLVD, DOWNEY, CA 90241-2362
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
21404
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1295794709
TYPE 1
CA
Enumeration date
03/20/2007
Last updated
08/22/2020
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