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5451 Laurel Canyon Blvd 102 Valley Village CA 91607-2180 | |
(818) 761-7109 | |
Not Available |
Full Name | |
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Speciality | Dentist |
Location | 5451 Laurel Canyon Blvd, Valley Village, California |
Authorized Official Name and Position | Yolanda E Cortez (DENTIST PROVIDER) |
Authorized Official Contact | 8187617109 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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5451 Laurel Canyon Blvd 102 Valley Villege CA 91607 Ph: (818) 761-7109 | 5451 Laurel Canyon Blvd 102 Valley Village CA 91607-2180 Ph: (818) 761-7109 |
NPI Number | 1396190443 |
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Provider Enumeration Date | 04/26/2016 |
Last Update Date | 04/26/2016 |
Identifier | Type | State | Issuer |
---|---|---|---|
1396190443 | NPI | - | NPPES |
56546 | Other | CA | DENTIST |
Taxonomy | Type | License (State) | Status |
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122300000X | Dentist | 56546 (California) | Primary |
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