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General NPI Number Information
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NPI Number | 1962873687
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Entity Type | Organization
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Legal Business Name | A. H. SHEILY, D.D.S., A DENTAL CORPORATION
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Dates
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Enumeration Date | 10/08/2015
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Last Update Date | 10/08/2015
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Provider Practice Location Address
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Address Line | 12756 W WASHINGTON BLVD
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City | LOS ANGELES
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State | CA
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Zip | 90066-2309
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Country | US
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Telephone | 310-574-8574
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Fax | 310-574-8899
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Provider Business Mailing Address
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Address Line | 12756 W WASHINGTON BLVD
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City | LOS ANGELES
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State | CA
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Zip | 90066-2309
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Country | US
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Telephone | 310-574-8574
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Fax | 310-574-8899
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. AARON H SHEILY
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Credential | D.D.S.
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Telephone | 310-574-8574
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 36833
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License Number State | CA
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