| Walter Jefferson Dental Corporation | |
|
962 Sepulveda Blvd Harbor City CA 90710-1405 | |
| (310) 539-3245 | |
| Not Available |
| Full Name | Walter Jefferson Dental Corporation |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 962 Sepulveda Blvd, Harbor City, California |
| Authorized Official Name and Position | Walter Jefferson (OWNER) |
| Authorized Official Contact | 3105393245 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Walter Jefferson Dental Corporation 17000 Red Hill Ave Irvine CA 92614-5626 Ph: (714) 845-8890 | Walter Jefferson Dental Corporation 962 Sepulveda Blvd Harbor City CA 90710-1405 Ph: (310) 539-3245 |
| NPI Number | 1437700952 |
|---|---|
| Provider Enumeration Date | 09/25/2019 |
| Last Update Date | 09/25/2019 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1437700952 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
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