| |
8205 Santa Monica Blvd Ste 12 W Hollywood CA 90046-5963 | |
(323) 654-1100 | |
Not Available |
Full Name | |
---|---|
Speciality | Clinic/center - Dental |
Location | 8205 Santa Monica Blvd Ste 12, W Hollywood, California |
Authorized Official Name and Position | Daniel Aaron Matatiaho (CEO) |
Authorized Official Contact | 3236541100 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
8205 Santa Monica Blvd Ste 12 W Hollywood CA 90046-5963 Ph: (323) 654-1100 | 8205 Santa Monica Blvd Ste 12 W Hollywood CA 90046-5963 Ph: (323) 654-1100 |
NPI Number | 1033978523 |
---|---|
Provider Enumeration Date | 03/18/2024 |
Last Update Date | 02/05/2025 |
Identifier | Type | State | Issuer |
---|---|---|---|
1033978523 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QD0000X | Clinic/center - Dental | (* (Not Available)) | Primary |
Victoria Olshansky D D S Inc Dental Clinic Medicare: Medicare Enrolled Practice Location: 1136 N Fairfax Ave, W Hollywood, CA 90046 Phone: 323-650-6936 | |