Larissa Gushansky, Dds Inc.

NPI 1003000928 - Dentist - 122300000X

NPI Details
NPI 1003000928
Enumeration Date 09/04/2007
Last Updated 09/04/2007
Entity Type Healthcare Provider
Active Over 9 years ago
Authorized Information
Name LARISSA LARISSA
Position PRESIDENT
Phone (909) 865-8595
Fax
Practice Location
887 E 2ND ST
SUITE B
POMONA CA, 91766-2009, US
Phone (909) 865-8595
Fax
Business Location
887 E 2ND ST
SUITE B
POMONA CA, 91766-2009, US
Phone (909) 865-8595
Fax
Toxanomy
Taxonomy Code 122300000X
License State California
License Number 36156
Remove 1003000928 NPI Number
 

According to our database, Larissa Gushansky, Dds Inc. NPI is 1003000928, taxonomy code is 122300000X and license number is 36156, license state is located at California. Larissa Gushansky, Dds Inc. physically located at 887 E 2nd St, Pomona CA, 91766-2009. NPI Number 1033115704 has the healthcare provider type.

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1003000928 NPI number is provided on an as is basis without warranty of any kind. 1003000928 is maintained by the National Plan & Provider Enumeration System. The contents of Larissa Gushansky, Dds Inc. are for informational purposes only.