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General NPI Number Information
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NPI Number | 1891986345
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Entity Type | Organization
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Legal Business Name | LOUIS F MASCOLA DDS INC
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Dates
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Enumeration Date | 08/08/2007
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Last Update Date | 04/06/2015
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Provider Practice Location Address
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Address Line | 770 W 9TH ST
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City | SAN PEDRO
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State | CA
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Zip | 90731-3602
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Country | US
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Telephone | 310-831-2377
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Fax | 310-831-0561
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Provider Business Mailing Address
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Address Line | 770 W 9TH ST
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City | SAN PEDRO
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State | CA
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Zip | 90731-3602
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Country | US
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Telephone | 310-831-2377
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Fax | 310-831-0561
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Authorized Official
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Title or Position | OWNER PRESIDENT
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Name | DR. LOUIS FRANK MASCOLA
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Credential | DDS
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Telephone | 310-831-2377
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number | 19931
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License Number State | CA
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