| |
12120 Saticoy St Ste. C North Hollywood CA 91605-3055 | |
(818) 255-2244 | |
(818) 255-2223 |
Full Name | |
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Speciality | Clinic/center - Dental |
Location | 12120 Saticoy St, North Hollywood, California |
Authorized Official Name and Position | Jacqueline V Lopez (DENTIST) |
Authorized Official Contact | 8182552244 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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12120 Saticoy St Ste. C North Hollywood CA 91605-3055 Ph: (818) 255-2244 | 12120 Saticoy St Ste. C North Hollywood CA 91605-3055 Ph: (818) 255-2244 |
NPI Number | 1649674581 |
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Provider Enumeration Date | 10/21/2014 |
Last Update Date | 10/21/2014 |
Identifier | Type | State | Issuer |
---|---|---|---|
1649674581 | NPI | - | NPPES |
210745 | Other | CA | ACCESS DENTAL ID |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QD0000X | Clinic/center - Dental | 62003 (California) | Primary |
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