Individual
DR. INDULAL M. NAGRECHA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
2509 PICO BLVD, VENICE FAMILY CLINIC, SANTA MONICA, CA 90405-1828
(310) 664-7885
(310) 664-7590
Mailing address
2509 PICO BLVD, VENICE FAMILY CLINIC, SANTA MONICA, CA 90405-1828
(310) 664-7885
(310) 664-7590
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
28962
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
B28962-01
DENTI-CAL
CA
Enumeration date
07/16/2006
Last updated
05/31/2012
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