| Shepard & Dos Santos Dental Corporation | |
|
310 E Grand Ave Ste 102 El Segundo CA 90245-3871 | |
| (760) 453-5702 | |
| Not Available |
| Full Name | Shepard & Dos Santos Dental Corporation |
|---|---|
| Speciality | Dentist |
| Location | 310 E Grand Ave Ste 102, El Segundo, California |
| Authorized Official Name and Position | Amanda Wolf Dos Santos (CEO) |
| Authorized Official Contact | 4242771138 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Shepard & Dos Santos Dental Corporation 310 E Grand Ave Ste 102 El Segundo CA 90245-3871 Ph: (760) 453-5702 | Shepard & Dos Santos Dental Corporation 310 E Grand Ave Ste 102 El Segundo CA 90245-3871 Ph: (760) 453-5702 |
| NPI Number | 1548707441 |
|---|---|
| Provider Enumeration Date | 01/30/2017 |
| Last Update Date | 01/30/2017 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1548707441 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 41704 (California) | Primary |
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