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General NPI Number Information
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NPI Number | 1831307610
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Entity Type | Organization
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Legal Business Name | TERESA M. AVENDANO-GALVEZ,DMD, A PROFESSIONAL CORPORATION
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Dates
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Enumeration Date | 05/18/2007
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Last Update Date | 03/27/2017
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Provider Practice Location Address
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Address Line | 1451 W ARTESIA BLVD STE 6
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City | GARDENA
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State | CA
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Zip | 90248-3232
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Country | US
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Telephone | 310-323-0290
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Fax |
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Provider Business Mailing Address
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Address Line | 1451 W ARTESIA BLVD STE 6
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City | GARDENA
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State | CA
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Zip | 90248-3232
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Country | US
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Telephone | 310-323-0290
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Fax |
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Authorized Official
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Title or Position | PRESIDENT- DENTIST OWNER
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Name | DR. TERESA MARTHA AVENDANO-GALVEZ
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Credential | D.M.D.
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Telephone | 310-323-0290
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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 | 37079
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License Number State | CA
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