| Diane Boval Dds A Professional Dental Corp | |
|
10149 Reseda Blvd Northridge CA 91324-1454 | |
| (562) 356-0948 | |
| (866) 817-3581 |
| Full Name | Diane Boval Dds A Professional Dental Corp |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 10149 Reseda Blvd, Northridge, California |
| Authorized Official Name and Position | Alan Boval (CHIEF EXECUTIVE OFFICER) |
| Authorized Official Contact | 5623560948 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Diane Boval Dds A Professional Dental Corp 901 W Whittier Blvd La Habra CA 90631-3743 Ph: (562) 356-0948 | Diane Boval Dds A Professional Dental Corp 10149 Reseda Blvd Northridge CA 91324-1454 Ph: (562) 356-0948 |
| NPI Number | 1154102531 |
|---|---|
| Provider Enumeration Date | 10/11/2023 |
| Last Update Date | 10/11/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1154102531 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
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