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General NPI Number Information
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NPI Number | 1346601903
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Entity Type | Organization
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Legal Business Name | ASUNCION REYES INC
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Dates
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Enumeration Date | 03/10/2016
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Last Update Date | 03/10/2016
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Provider Practice Location Address
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Address Line | 1321 N. VERMONT AVE. STE.3
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City | LOS ANGELES
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State | CA
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Zip | 90027
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Country | US
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Telephone | 323-669-3033
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Fax | 323-669-3028
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Provider Business Mailing Address
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Address Line | 1321 N. VERMONT AVE. STE.3
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City | LOS ANGELES
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State | CA
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Zip | 90027
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | ASUNCION REYES
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Credential |
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Telephone | 323-669-3033
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 49647
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License Number State | CA
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