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1720134091
MODESTO LUIS
SOUTH GATE, CA
NPI
1720134091
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
1223G0001X Dentist, General Practice
(Licence: CA 36401)
Enumeration Date
2007-01-26
Last Update Date
2007-07-09
Business Address
Dr. MODESTO LUIS DDS
4444 TWEEDY BLVD
SOUTH GATE, CA 90280-6304
Phone number: 323-564-2444
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Mailing Address
Dr. MODESTO LUIS DDS
5238 LOS CABALLEROS WAY
LOS ANGELES, CA 90027-1012
Phone number:
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