Provider First Line Business Practice Location Address:
UCLA SCHOOL OF DENTISTRY 10833 LE CONTE AVE CHS RM23086
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LOS ANGELES
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
90095-0001
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
310-486-9656
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
10/19/2021