| NPI | 1578885521 |
|---|---|
| Doing Business As | MADDISON AVENUE DENTAL |
| Entity Type | Organization |
| Authorized Contact | BEATRIZ HERNANDEZ Supervisor 714-578-6591 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 122300000X Dentist |
| Enumeration Date | 2010-02-18 |
| Last Update Date | 2018-11-01 |