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General NPI Number Information
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NPI Number | 1215318597
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Entity Type | Organization
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Legal Business Name | MARY FE G MONZON DDS INC
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Dates
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Enumeration Date | 06/12/2015
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Last Update Date | 05/16/2019
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Provider Practice Location Address
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Address Line | 2703 1/2 S VERMONT AVE
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City | LOS ANGELES
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State | CA
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Zip | 90007-2766
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Country | US
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Telephone | 323-735-7223
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Fax | 323-735-7222
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Provider Business Mailing Address
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Address Line | 2703 1/2 S VERMONT AVE
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City | LOS ANGELES
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State | CA
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Zip | 90007-2766
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Country | US
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Telephone | 323-735-7223
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Fax | 323-735-7222
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Authorized Official
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Title or Position | DENTIST/OWNER
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Name | DR. MARY FE GUIMAN MONZON
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Credential | DDS
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Telephone | 323-735-7223
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 48336
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License Number State | CA
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