Provider Demographics
NPI:1942395280
Name:DONLEVY & ESTESS ORAL SURGERY GROUP
Entity Type:Organization
Organization Name:DONLEVY & ESTESS ORAL SURGERY GROUP
Other - Org Name:POSEK, DONLEVY & YING
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:BUSINESS MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:KATHY
Authorized Official - Middle Name:
Authorized Official - Last Name:FERBER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:310-318-5970
Mailing Address - Street 1:1072 AVIATION BLVD
Mailing Address - Street 2:
Mailing Address - City:HERMOSA BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90254
Mailing Address - Country:US
Mailing Address - Phone:310-318-3333
Mailing Address - Fax:310-798-2566
Practice Address - Street 1:1072 AVIATION BLVD
Practice Address - Street 2:
Practice Address - City:HERMOSA BEACH
Practice Address - State:CA
Practice Address - Zip Code:90254
Practice Address - Country:US
Practice Address - Phone:310-318-3333
Practice Address - Fax:310-798-2566
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-03
Last Update Date:2017-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial SurgeryGroup - Single Specialty