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6423 Vineland Ave North Hollywood CA 91606-2712 | |
(310) 820-9933 | |
(310) 820-0408 |
Full Name | |
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Speciality | Dentist - Pediatric Dentistry |
Location | 6423 Vineland Ave, North Hollywood, California |
Authorized Official Name and Position | Miguel Reyes (Q/A CONTRACT & COMPLIANCE MANAGER) |
Authorized Official Contact | 3104094225 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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12121 Wilshire Blvd Ste 1111 Los Angeles CA 90025-1188 Ph: (310) 820-9933 | 6423 Vineland Ave North Hollywood CA 91606-2712 Ph: (310) 820-9933 |
NPI Number | 1780396796 |
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Provider Enumeration Date | 12/21/2022 |
Last Update Date | 04/20/2023 |
Identifier | Type | State | Issuer |
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1780396796 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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1223P0221X | Dentist - Pediatric Dentistry | (* (Not Available)) | Primary |
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