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General NPI Number Information
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NPI Number | 1942395280
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Entity Type | Organization
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Legal Business Name | DONLEVY & ESTESS ORAL SURGERY GROUP
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Dates
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Enumeration Date | 10/03/2006
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Last Update Date | 01/04/2017
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Provider Practice Location Address
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Address Line | 1072 AVIATION BLVD
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City | HERMOSA BEACH
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State | CA
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Zip | 90254
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Country | US
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Telephone | 310-318-3333
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Fax | 310-798-2566
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Provider Business Mailing Address
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Address Line | 1072 AVIATION BLVD
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City | HERMOSA BEACH
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State | CA
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Zip | 90254
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Country | US
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Telephone | 310-318-3333
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Fax | 310-798-2566
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Authorized Official
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Title or Position | BUSINESS MANAGER
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Name | KATHY FERBER
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Credential |
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Telephone | 310-318-5970
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223S0112X
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Taxonomy Name | Oral and Maxillofacial Surgery (Dentist)
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License Number |
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License Number State | CA
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