Provider Demographics
NPI:1508147125
Name:CARE PLUS FAMILY DENTAL
Entity Type:Organization
Organization Name:CARE PLUS FAMILY DENTAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:GODFREY
Authorized Official - Middle Name:
Authorized Official - Last Name:NWOGENE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:310-892-9904
Mailing Address - Street 1:8615 CRENSHAW BLVD
Mailing Address - Street 2:#C
Mailing Address - City:INGLEWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:90305
Mailing Address - Country:US
Mailing Address - Phone:310-892-9904
Mailing Address - Fax:310-677-1284
Practice Address - Street 1:8615 CRENSHAW BLVD
Practice Address - Street 2:#C
Practice Address - City:INGLEWOOD
Practice Address - State:CA
Practice Address - Zip Code:90305
Practice Address - Country:US
Practice Address - Phone:310-892-9904
Practice Address - Fax:310-677-1284
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-09-09
Last Update Date:2011-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental