Organization
WESTSIDE PEDIATRIC DENTAL GROUP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. EMMANUEL BERNARD GROSS DDS (PARTNER)
(310) 451-5748
Entity
Organization
Contact information
Practice address
1243 7TH ST, SANTA MONICA, CA 90401-1600
(310) 451-5748
Mailing address
1243 7TH ST, SANTA MONICA, CA 90401-1600
(310) 451-5748
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
—
—
Other
Enumeration date
07/26/2011
Last updated
07/26/2011
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