Organization
BAJO DMD & LIWANAG DMD INC
Active
Other names
Carson Family Dental Office
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ELENITA B LIWANAG DMD (DR VP)
(310) 835-7088
Entity
Organization
Contact information
Practice address
144 WEST CARSON ST, CARSON, CA 90745
(310) 835-4088
(310) 835-8488
Mailing address
144 WEST CARSON ST, CARSON, CA 90745
(310) 835-4088
(310) 835-8488
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
38027
CA
261QD0000X
Dental Clinic/Center
38963
CA
Other
Enumeration date
08/14/2006
Last updated
08/22/2020
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