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General NPI Number Information
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NPI Number | 1497113476
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Entity Type | Organization
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Legal Business Name | J.S.GO,D.D.S., INC.
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Dates
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Enumeration Date | 02/04/2016
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Last Update Date | 02/04/2016
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Provider Practice Location Address
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Address Line | 161 S HACIENDA BLVD
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City | CITY OF INDUSTRY
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State | CA
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Zip | 91745-1102
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Country | US
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Telephone | 626-968-9601
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Fax | 626-968-9603
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Provider Business Mailing Address
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Address Line | 161 S HACIENDA BLVD
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City | CITY OF INDUSTRY
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State | CA
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Zip | 91745-1102
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Country | US
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Telephone | 626-968-9601
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Fax | 626-968-9603
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. JULIA S GO
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Credential | D.D.S.
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Telephone | 626-968-9601
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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 | 27286
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License Number State | CA
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