Provider Demographics
NPI:1326306077
Name:N.L.QUIZON, D.D.S. AND A.L.QUIZON,D.D.S., INC
Entity Type:Organization
Organization Name:N.L.QUIZON, D.D.S. AND A.L.QUIZON,D.D.S., INC
Other - Org Name:EL CAMINO FAMILY DENTAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:AMELIA
Authorized Official - Middle Name:L
Authorized Official - Last Name:QUIZON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:310-327-0001
Mailing Address - Street 1:16300 CRENSHAW BLVD
Mailing Address - Street 2:SUITE 108
Mailing Address - City:TORRANCE
Mailing Address - State:CA
Mailing Address - Zip Code:90504-1439
Mailing Address - Country:US
Mailing Address - Phone:310-327-0001
Mailing Address - Fax:310-327-4011
Practice Address - Street 1:16300 CRENSHAW BLVD
Practice Address - Street 2:SUITE 108
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90504-1439
Practice Address - Country:US
Practice Address - Phone:310-327-0001
Practice Address - Fax:310-327-4011
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-05-01
Last Update Date:2012-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA418501223G0001X
CA479951223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty