Organization
PERIO IMPLANT HEALTH PROFESSIONALS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. WILLIAM MATOSKA D.D.S. (PERIODONTIST)
(213) 481-0664
Entity
Organization
Contact information
Practice address
1127 WILSHIRE BLVD, SUITE 1110, LOS ANGELES, CA 90017-3901
(213) 481-0664
(213) 481-2902
Mailing address
1127 WILSHIRE BLVD, SUITE 1110, LOS ANGELES, CA 90017-3901
(213) 481-0664
(213) 481-2902
Taxonomy
Speciality
Code
Description
License number
State
1223P0300X
Periodontics
Primary
26091
CA
Other
Enumeration date
05/22/2007
Last updated
08/22/2020
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