Healthcare Provider Details

I. General information

NPI: 1659576551
Provider Name (Legal Business Name): CHRISTOPHER ACONE DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/19/2007
Last Update Date: 09/10/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3220 SEPULVEDA BLVD SUITE 101
TORRANCE CA
90505-2744
US

IV. Provider business mailing address

3220 SEPULVEDA BLVD SUITE 101
TORRANCE CA
90505-2744
US

V. Phone/Fax

Practice location:
  • Phone: 424-263-4919
  • Fax: 424-263-4921
Mailing address:
  • Phone: 424-263-4919
  • Fax: 424-263-4921

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223P0300X
TaxonomyPeriodontics
License Number50879
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: