Provider Demographics
NPI:1174839922
Name:MASCOLA, NAKATA & ASSOCIATES DENTAL CORPORATION
Entity Type:Organization
Organization Name:MASCOLA, NAKATA & ASSOCIATES DENTAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:LOUIS
Authorized Official - Middle Name:FRANK
Authorized Official - Last Name:MASCOLA
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:310-773-5950
Mailing Address - Street 1:19000 HAWTHORNE BLVD
Mailing Address - Street 2:SUITE 400
Mailing Address - City:TORRANCE
Mailing Address - State:CA
Mailing Address - Zip Code:90503-1517
Mailing Address - Country:US
Mailing Address - Phone:310-773-5950
Mailing Address - Fax:310-347-4099
Practice Address - Street 1:19000 HAWTHORNE BLVD
Practice Address - Street 2:SUITE 400
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90503-1517
Practice Address - Country:US
Practice Address - Phone:310-773-5950
Practice Address - Fax:310-347-4099
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-08-30
Last Update Date:2010-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA199311223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty