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General NPI Number Information
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NPI Number | 1760509905
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Entity Type | Organization
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Legal Business Name | NORWALK PLAZA DENTISTRY INC
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Dates
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Enumeration Date | 03/23/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 11033 EAST ROSECRAWS AVENUE STE D
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City | NORWALK
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State | CA
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Zip | 90650
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Country | US
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Telephone | 562-929-3083
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Fax | 562-929-0113
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Provider Business Mailing Address
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Address Line | 11033 EAST ROSECRAWS AVENUE STE D
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City | NORWALK
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State | CA
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Zip | 90650
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Country | US
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Telephone | 562-929-3083
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Fax | 562-929-0113
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. FLORA CRUZ NAVARRO
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Credential | DMD
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Telephone | 562-929-3083
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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 | 33639
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License Number State | CA
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