Individual provider · Type 1 NPI
Porfirio S. Maravilla Jr., DENTIST
General Practice Dentistry · Los Angeles, CA
NPI number
1053492272
Active
Practice location
3540 Wilshire Blvd Ste 208
Los Angeles, CA 90010-2346
Fax (213) 388-9775
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| General Practice Dentistry Primary | 1223G0001X | 32356 (CA) |
General Practice Dentistry: A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.
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About NPI 1053492272
Porfirio S. Maravilla Jr., DENTIST's National Provider Identifier is 1053492272, issued on Oct 17, 2006. The primary taxonomy on file is General Practice Dentistry (1223G0001X), and the practice location is in Los Angeles, CA. The record was last updated on Jul 8, 2007.