Healthcare Provider Details

I. General information

NPI: 1043441280
Provider Name (Legal Business Name): MICHAEL K DOTE DDS, INC. APDC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/06/2009
Last Update Date: 08/06/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1700 W GARDENA BLVD
GARDENA CA
90247-4727
US

IV. Provider business mailing address

1700 W GARDENA BLVD
GARDENA CA
90247-4727
US

V. Phone/Fax

Practice location:
  • Phone: 310-323-3111
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QD0000X
TaxonomyDental Clinic/Center
License Number47366
License Number StateCA

VIII. Authorized Official

Name: DR. MICHAEL DOTE
Title or Position: PRESIDENT
Credential:
Phone: 310-323-3111