Larissa Gushansky Dds, Inc.

NPI #1831383140 in South Gate, California

Provider Information

NPI Number: 1831383140
Entity Type: Organization
Organization Name: Larissa Gushansky Dds, Inc.
Primary Specialty: Dentist
Enumeration Date: Aug 29, 2007
Last Updated: Aug 29, 2007

Practice Location

Address: 3175 FIRESTONE BLVD
Address 2: SUITE200
City: South Gate
State: California
ZIP Code: 90280-2951
Phone: (323) 563-9124

Authorized Official

Name: DR. LARISSA GUSHANSKY, D.D.S.
Title: PRESIDENT
Phone: (323) 563-9124

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist	122300000X	Primary

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