Anatoly Vaisman D.d.s., Inc | |
11273 Laurel Canyon Blvd Ste 3 San Fernando CA 91340-4358 | |
(818) 365-7191 | |
(818) 361-7641 |
Full Name | Anatoly Vaisman D.d.s., Inc |
---|---|
Speciality | Dentist - General Practice |
Location | 11273 Laurel Canyon Blvd Ste 3, San Fernando, California |
Authorized Official Name and Position | Maria Carlos (OFFICE MANAGE) |
Authorized Official Contact | 8183657191 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Anatoly Vaisman D.d.s., Inc 11273 Laurel Canyon Blvd Ste 3 San Fernando CA 91340-4358 Ph: (818) 365-7191 | Anatoly Vaisman D.d.s., Inc 11273 Laurel Canyon Blvd Ste 3 San Fernando CA 91340-4358 Ph: (818) 365-7191 |
NPI Number | 1235371600 |
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Provider Enumeration Date | 04/01/2009 |
Last Update Date | 04/01/2009 |
Identifier | Type | State | Issuer |
---|---|---|---|
1235371600 | NPI | - | NPPES |
G93630-01 | Medicaid | CA |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
1223G0001X | Dentist - General Practice | 43259 (California) | Primary |
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