Provider Demographics
NPI:1851555221
Name:DOWNEY DENTAL CARE
Entity Type:Organization
Organization Name:DOWNEY DENTAL CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:FLORA
Authorized Official - Middle Name:CASTILLO
Authorized Official - Last Name:LARA
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:562-869-3443
Mailing Address - Street 1:10343 LAKEWOOD BLVD
Mailing Address - Street 2:
Mailing Address - City:DOWNEY
Mailing Address - State:CA
Mailing Address - Zip Code:90241-2743
Mailing Address - Country:US
Mailing Address - Phone:562-869-3443
Mailing Address - Fax:562-869-6663
Practice Address - Street 1:10343 LAKEWOOD BLVD
Practice Address - Street 2:
Practice Address - City:DOWNEY
Practice Address - State:CA
Practice Address - Zip Code:90241-2743
Practice Address - Country:US
Practice Address - Phone:562-869-3443
Practice Address - Fax:562-869-6663
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-15
Last Update Date:2008-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA43454122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty