Provider Demographics
NPI:1457509309
Name:ALL FRIENDS DENTAL CENTER
Entity Type:Organization
Organization Name:ALL FRIENDS DENTAL CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:IPING
Authorized Official - Middle Name:
Authorized Official - Last Name:LIU
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:310-808-0198
Mailing Address - Street 1:1600 W REDONDO BEACH BLVD
Mailing Address - Street 2:#203
Mailing Address - City:GARDENA
Mailing Address - State:CA
Mailing Address - Zip Code:90247-3226
Mailing Address - Country:US
Mailing Address - Phone:310-808-0198
Mailing Address - Fax:310-808-0138
Practice Address - Street 1:1600 W REDONDO BEACH BLVD
Practice Address - Street 2:#203
Practice Address - City:GARDENA
Practice Address - State:CA
Practice Address - Zip Code:90247-3226
Practice Address - Country:US
Practice Address - Phone:310-808-0198
Practice Address - Fax:310-808-0138
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-09-04
Last Update Date:2008-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA292311223G0001X
CA325611223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty