Dentalville
Dentist in Panorama City, CA. Organization (NPI-2).
NPI number1639375488
StatusActive
Last updated in NPPESAug 22, 2020
Details
- NPI
- 1639375488
- Entity type
- Organization (NPI-2)
- Legal business name
- Dentalville
- Organization subpart
- No
- Enumeration date
- Jun 26, 2007
- Last updated
- Aug 22, 2020
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 122300000X | Dentist | B26405-03 | CA | Yes |
Practice location
7864 Van Nuys BlvdPanorama City, CA 91402-6069
Phone 818-989-2400 · Fax 818-989-2457
Mailing address
7864 Van Nuys BlvdPanorama City, CA 91402-6069
Phone 818-989-2400 · Fax 818-989-2457
Authorized official
Leonid Glosman
Owner
3232661000
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