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General NPI Number Information
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NPI Number | 1144048661
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Entity Type | Organization
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Legal Business Name | MARISSA M CARVALHO DDS INC
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Dates
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Enumeration Date | 10/02/2024
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Last Update Date | 10/02/2024
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Provider Practice Location Address
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Address Line | 2780 SKYPARK DR STE 240
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City | TORRANCE
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State | CA
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Zip | 90505-5341
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Country | US
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Telephone | 424-458-6007
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Fax | 424-337-8055
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Provider Business Mailing Address
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Address Line | 4318 W 165TH ST
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City | LAWNDALE
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State | CA
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Zip | 90260-2926
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Country | US
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Telephone | 310-408-9585
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. MARISSA MARGARET CARVALHO
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Credential | DDS
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Telephone | 424-458-6007
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number |
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License Number State |
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