Organization
CELIA P. OCTOMAN, DMD, INC.
Active
Other names
Central Dental Care
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CELIA PONCE OCTOMAN DDS (PRESIDENT)
(213) 353-9930
Entity
Organization
Contact information
Practice address
2023 BEVERLY BLVD, LOS ANGELES, CA 90057-2417
(213) 353-9930
(213) 353-0990
Mailing address
2023 BEVERLY BLVD, LOS ANGELES, CA 90057-2417
(213) 353-9930
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
30490
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
D30490
DENTICAL
CA
Enumeration date
01/11/2007
Last updated
02/08/2008
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