Organization
CHILDRENS DENTISTRY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PERCY MILLS (MANAGER)
(310) 672-7822
Entity
Organization
Contact information
Practice address
345 E MANCHESTER BLVD, INGLEWOOD, CA 90301-1814
(310) 672-7822
(310) 330-3722
Mailing address
345 E MANCHESTER BLVD, INGLEWOOD, CA 90301-1814
(310) 672-7822
(310) 330-0722
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
29015
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
D29015
—
CA
Enumeration date
03/18/2013
Last updated
03/18/2013
Update your record
If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.
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