Organization · Type 2 NPI

Mia Larissa Ancheta, Dds, A Dental Corporation

Dental Clinic/Center · South Gate, CA

NPI number 1306398680 Active

Practice location

8720 Garfield Ave Ste 104
South Gate, CA 90280-3720

Call (562) 927-9050 Map

Fax (562) 927-9060

Other practice locations

8720 Garfield Ave Ste 104, South Gate, CA 90280-3720 · (562) 927-9050

Specialties and licenses

Taxonomy	Code	License
Dental Clinic/Center Primary	261QD0000X	47839 (CA)

Dental Clinic/Center: Definition to come...

Another provider at this address

Luis Moran DDS A Dental CorporationGeneral Practice Dentistry South Gate, CA NPI 1326228446

Other dental clinic/center providers in South Gate

See all in South Gate →

NPI record

NPI: 1306398680
Entity type: Organization (Type 2)
Issued: Nov 2, 2016
Last updated: Oct 25, 2022
Status: Active

Other names

<unavail>
Mars Dental Group · doing business as
San Angel Dental, Office of Mia Ancheta · doing business as
San Angel Dental Management Company · former legal business name

Authorized official

Mia Larissa Ancheta, DDS
CEO
(562) 927-9050

Verify this record

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About NPI 1306398680

Mia Larissa Ancheta, Dds, A Dental Corporation's National Provider Identifier is 1306398680, issued on Nov 2, 2016. The primary taxonomy on file is Dental Clinic/Center (261QD0000X), and the practice location is in South Gate, CA. The record was last updated on Oct 25, 2022.