Provider First Line Business Practice Location Address:
4855 SANTA MONICA BLVD.
Provider Second Line Business Practice Location Address:
VISAYAS B. MONTEJO, DMD SUITE #111
Provider Business Practice Location Address City Name:
LOS ANGELES
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
90029
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
323-664-9363
Provider Business Practice Location Address Fax Number:
323-668-2851
Provider Enumeration Date:
08/17/2006