Provider First Line Business Practice Location Address:
UNIV OF S CALIF SCHOOL OF DENTISTRY
Provider Second Line Business Practice Location Address:
925 W.34TH ST. RM. # 4208
Provider Business Practice Location Address City Name:
LOS ANGELES
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
90089-0001
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
213-821-6814
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
04/07/2011