Organization
SUSAN A SHEETS DDS A PROFESSIONAL DENTAL CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SUSAN SHEETS DDS (OWNER)
(310) 832-2657
Entity
Organization
Contact information
Practice address
2515 S WESTERN AVE, STE 109, SAN PEDRO, CA 90732-4643
(310) 832-2657
(310) 832-5164
Mailing address
2515 S WESTERN AVE, STE 109, SAN PEDRO, CA 90732-4643
(310) 832-2657
(310) 832-5164
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
—
—
332BC3200X
Customized Equipment (DME)
Primary
—
—
Other
Enumeration date
06/01/2015
Last updated
06/01/2015
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