Provider First Line Business Practice Location Address:
12121 WILSHIRE BLVD. SUITE1111
Provider Second Line Business Practice Location Address:
WEST COAST DENTAL SERVICES
Provider Business Practice Location Address City Name:
LOS ANGELES
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
90025
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
310-409-4265
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
07/16/2013