| Encino Dental Group Inc A Professional Dental Corp | |
|
17777 Ventura Blvd Ste 210 Encino CA 91316-3748 | |
| (818) 433-1502 | |
| Not Available |
| Full Name | Encino Dental Group Inc A Professional Dental Corp |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 17777 Ventura Blvd Ste 210, Encino, California |
| Authorized Official Name and Position | Josef Mamaliger (OWNER) |
| Authorized Official Contact | 8186548300 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Encino Dental Group Inc A Professional Dental Corp 17777 Ventura Blvd Ste 210 Encino CA 91316-3748 Ph: (818) 433-1502 | Encino Dental Group Inc A Professional Dental Corp 17777 Ventura Blvd Ste 210 Encino CA 91316-3748 Ph: (818) 433-1502 |
| NPI Number | 1891333118 |
|---|---|
| Provider Enumeration Date | 12/17/2019 |
| Last Update Date | 12/17/2019 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1891333118 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | (* (Not Available)) | Primary |
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