Individual
DR. CELIA PONCE OCTOMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
D.D.S.
Contact information
Practice address
2023 BEVERLY BLVD, LOS ANGELES, CA 90057-2417
(213) 353-9930
Mailing address
2023 BEVERLY BLVD., LOS ANGELES, CA 90057
(213) 353-9930
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
30490
CA
Other
Enumeration date
01/31/2008
Last updated
01/31/2008
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