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)CodeLicenseStatePrimary
General Practice Dentistry
Group: 193400000X MULTIPLE SINGLE SPECIALTY GROUP
1223G0001X 20092 CA Yes
General Practice Dentistry
Group: 193400000X MULTIPLE SINGLE SPECIALTY GROUP
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

Other providers in Downey, CA

All providers in Downey, CA · General Practice Dentistry in California

Sources for this page

Verify at the official NPI Registry.