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NPI Code Detail

MEDICARE: VERTNER J. WHITE DENTAL CORPORATION

MEDICARE: VERTNER J. WHITE DENTAL CORPORATION
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11223G0001XGeneral Practice Dentistry28926CA

General Provider Information

NPI Number : 1326141870
Entity Type Code : Organization
Provider Name (Legal Business Name) : VERTNER J. WHITE DENTAL CORPORATION
Provider Business Mailing Address
First Line : PO BOX 11066
Second Line :
City : LOS ANGELES
State : CA
Zip : 90011-0066
Country : US
Telephone Number : 323-231-2108
Fax Number : 323-231-1186
Provider Business Practice Location Address
First Line : 2711 S CENTRAL AVE
Second Line :
City : LOS ANGELES
State : CA
Zip : 90011-5527
Country : US
Telephone Number : 323-231-2108
Fax Number : 323-231-1186
Authorized Official
Title or Position : OWNER
Name : DR. KATHERINE L FORBES
Credential : D.D.S.
Telephone Number : 323-231-2108
Provider Enumeration Date : 09/07/2006
Last Update Date : 08/22/2020

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Directions to “VERTNER J. WHITE DENTAL CORPORATION ” Practice Location

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