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NPI 1639550361

NPI 1639550361 : DON C ATKINS III : LONG BEACH, CA

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General NPI Number Information
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    NPI Number           |    1639550361
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    Entity Type          |    Organization 
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    Legal Business Name  |    DON C ATKINS III 
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Dates
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    Enumeration Date     |    06/18/2015
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    Last Update Date     |    07/13/2015
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Provider Practice Location Address
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    Address Line         |    4440 E VILLAGE RD 
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    City                 |    LONG BEACH
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    State                |    CA
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    Zip                  |    90808-1540
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    Country              |    US
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    Telephone            |    562-425-3311
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    4440 E VILLAGE RD 
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    City                 |    LONG BEACH
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    State                |    CA
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    Zip                  |    90808-1540
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    Country              |    US
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    Telephone            |    562-425-3311
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    Fax                  |    
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Authorized Official
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    Title or Position    |    OWNER
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    Name                 |     DON C ATKINS 
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    Credential           |    DDS
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    Telephone            |    562-425-3311
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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       |    27227
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    License Number State |    CA
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