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General NPI Number Information
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NPI Number | 1326266198
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Entity Type | Organization
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Legal Business Name | CENTRAL ENDODONTICS INC
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Dates
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Enumeration Date | 04/24/2007
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Last Update Date | 12/09/2020
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Provider Practice Location Address
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Address Line | 2711 SANTA ANA ST
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City | SOUTH GATE
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State | CA
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Zip | 90280-2021
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Country | US
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Telephone | 323-277-0600
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Fax |
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Provider Business Mailing Address
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Address Line | 2711 SANTA ANA ST
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City | SOUTH GATE
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State | CA
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Zip | 90280-2021
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Country | US
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Telephone | 323-277-0600
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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. KWOR CHIEH LOO
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Credential | D.D.S.
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Telephone | 626-475-7424
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223E0200X
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Taxonomy Name | Endodontics
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License Number | 45489
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License Number State | CA
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