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General NPI Number Information
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NPI Number | 1841691425
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Entity Type | Organization
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Legal Business Name | DANIEL SUR DDS, INC.
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Dates
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Enumeration Date | 09/15/2014
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Last Update Date | 09/15/2014
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Provider Practice Location Address
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Address Line | 4749 E CESAR E CHAVEZ AVE
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City | LOS ANGELES
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State | CA
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Zip | 90022-1209
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Country | US
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Telephone | 323-268-2881
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Fax | 323-268-2181
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Provider Business Mailing Address
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Address Line | 4749 E CESAR E CHAVEZ AVE
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City | LOS ANGELES
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State | CA
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Zip | 90022-1209
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Country | US
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Telephone | 323-268-2881
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Fax | 323-268-2181
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Authorized Official
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Title or Position | CEO
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Name | DANIEL SUR
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Credential |
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Telephone | 661-607-8515
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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 | 51139
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License Number State | CA
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