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General NPI Number Information
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NPI Number | 1750735296
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Entity Type | Organization
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Legal Business Name | VICTOR DE LOS SANTOS, DDS
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Dates
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Enumeration Date | 04/21/2016
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Last Update Date | 04/21/2016
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Provider Practice Location Address
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Address Line | 201 S ALVARADO STREET SUITE 402
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City | LOS ANGELES
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State | CA
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Zip | 90057
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Country | US
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Telephone | 213-484-2919
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Fax | 213-484-2132
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Provider Business Mailing Address
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Address Line | 201 S ALVARADO ST SUITE #402
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City | LOS ANGELES
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State | CA
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Zip | 90057-2320
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Country | US
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Telephone | 213-484-2919
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Fax | 213-484-2132
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Authorized Official
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Title or Position | DENTIST
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Name | DR. VICTOR DE LOS SANTOS
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Credential | D.D.S.
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Telephone | 626-297-1391
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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 | 36534
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License Number State | CA
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