Provider First Line Business Practice Location Address:
925 W 34TH ST STE 127
Provider Second Line Business Practice Location Address:
OSTROW SCHOOL OF DENTISTRY OF USC
Provider Business Practice Location Address City Name:
LOS ANGELES
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
90089-0058
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
213-740-3410
Provider Business Practice Location Address Fax Number:
213-740-3573
Provider Enumeration Date:
10/06/2014