| |
12626 Riverside Dr Ste 403 Studio City CA 91607-3420 | |
(818) 980-0998 | |
(818) 980-0991 |
Full Name | |
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Speciality | Dentist - Endodontics |
Location | 12626 Riverside Dr, Studio City, California |
Authorized Official Name and Position | Lyla Boustani (PRESIDENT) |
Authorized Official Contact | 8189800998 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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12626 Riverside Dr Ste 403 Studio City CA 91607-3420 Ph: (818) 980-0998 | 12626 Riverside Dr Ste 403 Studio City CA 91607-3420 Ph: (818) 980-0998 |
NPI Number | 1538585294 |
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Provider Enumeration Date | 03/05/2014 |
Last Update Date | 03/05/2014 |
Identifier | Type | State | Issuer |
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1538585294 | NPI | - | NPPES |
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