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General NPI Number Information
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NPI Number | 1508147125
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Entity Type | Organization
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Legal Business Name | CARE PLUS FAMILY DENTAL
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Dates
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Enumeration Date | 09/09/2011
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Last Update Date | 09/09/2011
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Provider Practice Location Address
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Address Line | 8615 CRENSHAW BLVD #C
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City | INGLEWOOD
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State | CA
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Zip | 90305
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Country | US
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Telephone | 310-892-9904
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Fax | 310-677-1284
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Provider Business Mailing Address
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Address Line | 8615 CRENSHAW BLVD #C
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City | INGLEWOOD
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State | CA
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Zip | 90305
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Country | US
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Telephone | 310-892-9904
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Fax | 310-677-1284
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Authorized Official
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Title or Position | DIRECTOR
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Name | MR. GODFREY NWOGENE
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Credential |
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Telephone | 310-892-9904
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number |
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License Number State |
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