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Provider Information for 1437337938



DR. NANCY AZYADETH LARA D.D.S.

Gender: FEMALE

Individual NPI: 1437337938

Calendar   Last Updated:  2008-02-06
  Certification Date: 

Details

Name Value
NPI 1437337938
Enumeration Date 2008-02-06
NPI Type 1 - Individual
Sole Proprietor NO
Status Active
Mailing Address 3011 ROWENA AVE APT 2
LOS ANGELES, CA 90039-2021
United States

Phone: | Fax:
View Map External Link
Primary Practice Address 6615 SEVILLE AVE
HUNTINGTON PARK, CA 90255-4801
United States

Phone: 323-581-1010 | Fax:
View Map External Link
Health Information Exchange
Endpoint Type Endpoint Endpoint Description Use Content Type Affiliation Endpoint Location
Other Identifiers
Issuer State Number
Taxonomy
Primary Taxonomy Selected Taxonomy State License Number
Yes 122300000X - Dentist CA 56194