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General NPI Number Information
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NPI Number | 1932496387
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Entity Type | Organization
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Legal Business Name | LOUIS F. MASCOLA, D.D.S. AND JAMES LOOS, D.D.S., A PROFESSIONAL DENTAL
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Dates
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Enumeration Date | 07/06/2011
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Last Update Date | 07/06/2011
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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 | 310-856-6401
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Fax |
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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 | 310-856-6401
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | LOUIS F MASCOLA
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Credential | DDS
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Telephone | 310-856-6401
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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 |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number |
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License Number State |
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