Organization
MANDALAY CREST MANAGEMENT GROUP INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. FLOYD JESSE CAWTHON III DDS (PRESIDENT)
(805) 479-8706
Entity
Organization
Contact information
Practice address
18663 VENTURA BLVD, #200, TARZANA, CA 91356-4197
(805) 479-8706
Mailing address
4924 BALBOA BLVD, #223, ENCINO, CA 91316-3402
(805) 479-8706
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
32043
CA
Other
Enumeration date
03/10/2010
Last updated
07/19/2010
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