| Rochelle Skinner Dds Dental Corporation | |
|
9702 Venice Blvd Suite B Culver City CA 90232 | |
| (310) 895-9885 | |
| (310) 895-7657 |
| Full Name | Rochelle Skinner Dds Dental Corporation |
|---|---|
| Speciality | Dentist |
| Location | 9702 Venice Blvd, Culver City, California |
| Authorized Official Name and Position | Rochelle Skinner (OWNER) |
| Authorized Official Contact | 8166166009 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Rochelle Skinner Dds Dental Corporation 9702 Venice Blvd Suite B Culver City CA 90232 Ph: (310) 895-9885 | Rochelle Skinner Dds Dental Corporation 9702 Venice Blvd Suite B Culver City CA 90232 Ph: (310) 895-9885 |
| NPI Number | 1235554908 |
|---|---|
| Provider Enumeration Date | 03/04/2014 |
| Last Update Date | 03/04/2014 |
| Medicare PECOS PAC ID | 7618191966 |
|---|---|
| Medicare Enrollment ID | O20140606002002 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1235554908 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | (* (Not Available)) | Primary |
| Provider Name | Rochelle R Skinner |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1578832630 PECOS PAC ID: 8527282870 Enrollment ID: I20140606002004 |
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