NPI 1356518310 · live from the CMS NPI Registry
A Beautiful Smile Means A Better Life 3
Dentist, General Practice in Long Beach, CA. National Provider Identifier 1356518310, active.
NPI record
| NPI | 1356518310 Type 2 · organization |
|---|---|
| Status | Active |
| Primary specialty | Dentist, General Practice 1223G0001X |
| Practice location | 5512 Britton Dr Ste 208, Long Beach, CA 90815 |
| Practice phone | 562-430-2740 |
| Enumerated | May 9, 2008 |
| Last updated | May 9, 2008 |
| Authorized official | Gary Crockett, Owner |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Dentist, General Practice | 1223G0001X | 50687 (CA) |
| Dentist, General Practice primary | 1223G0001X | 20092 (CA) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.