Provider First Line Business Practice Location Address:
1725 W. 6TH STREET
Provider Second Line Business Practice Location Address:
WEST COAST DENTAL 6TH STREET
Provider Business Practice Location Address City Name:
LOS ANGELES
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
90017
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
213-413-5151
Provider Business Practice Location Address Fax Number:
213-413-7171
Provider Enumeration Date:
01/21/2009