| Walter Jefferson, D.d.s., Inc. | |
|
612 E Carson St Suite 101 Carson CA 90745 | |
| (310) 469-9355 | |
| (310) 414-0800 |
| Full Name | Walter Jefferson, D.d.s., Inc. |
|---|---|
| Speciality | Dentist |
| Location | 612 E Carson St, Carson, California |
| Authorized Official Name and Position | Walter Jefferson (OWNER) |
| Authorized Official Contact | 3104699355 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Walter Jefferson, D.d.s., Inc. 17000 Red Hill Avenue Irvine CA 92614 Ph: (714) 845-8890 | Walter Jefferson, D.d.s., Inc. 612 E Carson St Suite 101 Carson CA 90745 Ph: (310) 469-9355 |
| NPI Number | 1295270734 |
|---|---|
| Provider Enumeration Date | 12/19/2016 |
| Last Update Date | 12/22/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1295270734 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | (* (Not Available)) | Primary |
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