A Beautiful Smile Means a Better Life 2
Organization Active NPI General Practice Dentistry · Downey, CA
NPI 1154588895 · NPPES record last updated May 20, 2008
Key facts
- NPI
- 1154588895
- Entity type
- Organization (NPI type 2)
- Primary specialty
- General Practice Dentistry 1223G0001X
- License
- 20092 (CA)
- Legal business name
- A BEAUTIFUL SMILE MEANS A BETTER LIFE 2
- Practice address
- 11411 Brookshire Ave Ste 405
Downey, CA 90241 - Phone
- (562) 861-0496
- Fax
- (562) 861-4153
- NPI assigned
- May 20, 2008
- Organization subpart
- No
Authorized official
- Name
- Gary R Crockett, DDS
- Title
- Owner
- Phone
- (562) 861-0496
National Provider Directory
Locations
11411 Brookshire Ave
Ste 405
Downey, CA 90241
Phone (314) 941-8029
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry |
1223G0001X | 20092 | CA | Yes |
| General Practice Dentistry |
1223G0001X | 50687 | CA |
Addresses
Primary practice location
11411 Brookshire Ave Ste 405
Downey, CA 90241
Mailing address
11411 Brookshire Ave Ste 405
Downey, CA 90241
Phone (562) 861-0496
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All providers in Downey, CA · General Practice Dentistry in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 20, 2008. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.