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General NPI Number Information
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NPI Number | 1548316037
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Entity Type | Organization
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Legal Business Name | MERCEDITAS R. SINSIOCO, DMD, INC.
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Dates
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Enumeration Date | 01/26/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 2413 PACIFIC COAST HWY SUITE 203
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City | LOMITA
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State | CA
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Zip | 90717-2395
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Country | US
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Telephone | 310-326-3944
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Fax | 310-326-3638
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Provider Business Mailing Address
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Address Line | 2413 PACIFIC COAST HWY SUITE 203
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City | LOMITA
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State | CA
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Zip | 90717-2395
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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 | PRESIDENT
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Name | DR. MERCEDITAS RIVERA SINSIOCO
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Credential | D.M.D.
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Telephone | 310-326-3944
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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 | 40008
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License Number State | CA
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