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General NPI Number Information
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NPI Number | 1801323696
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Entity Type | Organization
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Legal Business Name | NDIDI ONUGHA UKA DDS INC
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Dates
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Enumeration Date | 05/11/2017
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Last Update Date | 05/11/2017
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Provider Practice Location Address
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Address Line | 441 E CARSON ST SUITE N
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City | CARSON
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State | CA
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Zip | 90745-2767
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Country | US
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Telephone | 310-835-3969
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Fax |
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Provider Business Mailing Address
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Address Line | 732 255TH ST UNIT E
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City | HARBOR CITY
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State | CA
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Zip | 90710-3149
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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 | OWNER
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Name | NDIDI UKA
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Credential |
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Telephone | 310-926-3570
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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 | 60123
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License Number State | CA
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