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NPI Code Detail

MEDICARE: JOSH LAGATTA DDS INC

MEDICARE: JOSH LAGATTA DDS INC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1122300000XDentistD49919CA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1G93176-03OTHERCAMEDICAL-DENTICAL

General Provider Information

NPI Number : 1104089796
Entity Type Code : Organization
Provider Name (Legal Business Name) : JOSH LAGATTA DDS INC
Provider Business Mailing Address
First Line : 1201 E FLORENCE AVE # B
Second Line :
City : LOS ANGELES
State : CA
Zip : 90001-2432
Country : US
Telephone Number : 562-773-6057
Fax Number :
Provider Business Practice Location Address
First Line : 1201 E FLORENCE AVE # B
Second Line :
City : LOS ANGELES
State : CA
Zip : 90001-2432
Country : US
Telephone Number : 562-773-6057
Fax Number :
Authorized Official
Title or Position : PRESIDENT
Name : DR. JOSH JAMES LAGATTA
Credential : DDS
Telephone Number : 323-585-7200
Provider Enumeration Date : 07/03/2008
Last Update Date : 07/03/2008

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Directions to “JOSH LAGATTA DDS INC ” Practice Location

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